It's officially flu season, and the number of H1N1 (swine) flu cases is on the rise. Symptoms of H1N1 and other flus include body aches, high fever, cough, sore throat, and congestion. People with diabetes are at an increased risk for infection, and the Centers for Disease Control and Prevention recommends they get vaccinated as soon as the H1N1 vaccine becomes available as well as get a seasonal flu shot. The H1N1 vaccine will start arriving at healthcare facilities around the United States this week.

As the information becomes available, you can find out where to get a flu shot here.

Even vaccinated people can get sick, though, so it is important to be prepared for whatever this season has in store--not just H1N1 but typical seasonal cold and flu viruses. Not only are people with diabetes more susceptible to getting sick, but illness may be particularly dangerous for them. (It's feared that the 2009 H1N1 may make a lot of people sick, but it is not yet clear whether it will be more severe than seasonal flu.)

Here are some things to keep in mind when sickness strikes.

Check Blood Glucose
Getting a bug can wreak havoc on the body, including upsetting the balance among the hormones that regulate blood glucose. In some cases, blood glucose levels can get so high that severe complications can arise, such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS). For this reason, monitoring blood glucose during an illness is especially important. You should also be aware that over-the-counter medicines may contain ingredients that can affect blood glucose levels, such as alcohol--which is common in nighttime cough medicines--sugar, and pseudoephedrine.

Take Your Meds
Even if you feel sick and aren't eating as much as usual, continue to take your glucose-lowering medications. Blood glucose may rise even without food during an illness because of hormone imbalances. Not taking enough insulin during an illness is a common cause of DKA.

Drink Fluids, Replace Carbs
Loss of appetite or vomiting can make staying nourished a chore while sick. Sports drinks can replace missed carbs, which may help prevent hypoglycemia (low blood glucose). Drinking lots of calorie-free liquids, like water, is important, too. Staying hydrated will help your body fight the illness and prevent complications.

Call a Doctor if...

• You aren't getting better after a day or two.
• Vomiting or diarrhea lasts for more than six hours.
• A ketone test (which you can buy at a pharmacy) shows too many ketones in your urine.
• In spite of medication, your blood glucose levels remain consistently above 250 mg/dl.
• You have signs of very high blood glucose like dry mouth, fruity breath odor, or disorientation.
• Abdominal or chest pain is severe.
• Breathing becomes difficult.

Be ready to tell your doctor details about your symptoms and blood glucose levels, and the medications you are taking.

In preparation for flu season, work out a sick-day action plan with your health care provider that lays out under what circumstances you should call your doctor, how often you should check your blood glucose, whether you need to monitor your urine for ketones, how to deal with both regular and over-the-counter medications, and how to select foods and liquids that will help you fight with flu without disrupting your diabetes management.

No one likes getting sick, and people with diabetes face a set of special challenges. But following these guidelines should help put you on the path to getting well.