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Summer is winding down and fall is fast approaching along with the flu season. It is extremely important for all of us to follow the CDC and healthcare providers recommendations regarding immunizations, especially those living with Diabetes.

Diabetes affects the immune system increasing risks of developing Hepatitis B, complications from the flu and pneumonia. Immunizations and developing a plan for sick days helps lower these risks, keeps blood sugar under control preventing serious conditions and hospitalizations.

The American Diabetes Association recommends the following immunizations for those living with Diabetes:
1.   Flu: annually, 6 months and older
2.   Pneumonia: PCV13: children before 2, PPSV23: 2-64 years old, age 65 and older require additional dose
3.   Hepatitis B: 3 dose series, unvaccinated adults 19-59, (consider for those age 60 and older)
4.   Routine CDC recommended age specific vaccines

Along with receiving these recommended immunizations, those living with Diabetes need to develop a plan for sick days. This is important because illness stresses the body releasing hormones that elevate blood sugar, interfere with Diabetes medication effectiveness and can lead to serious, potentially dangerous conditions.

Developing an individualized sick day plan requires working together with the healthcare provider and/or Diabetes team ahead of time so when the person becomes sick, they will know what to do and will have the supplies on hand to carry out the plan.

The American Diabetes Association provides general sick day guidelines for those living with Diabetes:
1.  Call healthcare provider or Diabetes team when:
        *   Sick or had a fever for a couple of days and not getting better
        *   Vomiting or diarrhea more than 6 hours
        *   Moderate to large ketones in urine
        *   Blood sugar higher than 240, despite insulin adjustments or if taking oral medications longer than 24 hours
        *   Symptoms signaling more serious condition (trouble breathing, fruity breath, lips/tongue dry, cracked)
2.  Increase frequency of blood sugar, urine ketone monitoring, record results
3.  Continue taking Diabetes medications, especially insulin, even if vomiting
4.  Stick to normal meal plan, stay hydrated, drink lots of sugar free liquids
5.  Carefully choose over the counter cold medications

Being proactive, staying up to date with recommended immunizations and preplanning for sick days is essential for all of us, but especially important for those living with Diabetes!

To learn more about CDC recommended vaccines and living with Diabetes:
http://www.cdc.gov/vaccines/schedules
http://www.diabetes.org/living-with-diabetes/