Swine flu, also known as the H1N1 virus, is expected to make a strong- er impact on the American public this fall than it did this past spring and summer. When it comes to flu, after all, cold and inclement weather mixed with kids going back to school is a scary combination that increases your chances for getting sick. Julie Gerberding, MD, MPH, the former director of the U.S. Centers for Disease Control and Prevention (CDC) and a specialist in the field of infectious diseases, offers these thoughts to help keep you safe.
Diabetes Health Monitor: Should people with diabetes be especially concerned about swine flu?
Dr. Gerberding: People with chronic medical conditions like diabetes are more vulnerable to serious disease, such as influenza. So this flu will likely have a higher impact on them.
DHM: What should people with chronic health problems do to avoid getting swine flu?
Dr. Gerberding: Be especially conscientious about getting vaccines and follow commonsense precautions. We may not have the vaccine available at the time the swine flu comes back in full force, so we will have to rely on other means. We must try to prevent exposure and spread by learning to recognize a flu-like illness early and to start treatment as early as possible. Call your medical provider and seek consultation by phone if you develop any flu symptoms. Generally, if you wait more than 48 hours after you have your first symptoms, the drugs are a lot less effective.
DHM: What symptoms should people look for?
Dr. Gerberding: The hallmark is always fever. But even when they are very sick, people with severe diabetes don’t always develop high fever. So pay attention to broader issues—unusual fatigue and respiratory symptoms, particularly cough. Swine flu virus has a disproportionate impact on the respiratory tract. It may cause gastrointestinal symptoms, too. If you suddenly find your blood sugar is higher than you expect when you are not feeling well, that’s also an important reason to be more alert to the possibility of an early viral infection.
DHM: Why do you recommend a patient call the doctor instead of going to the emergency room or to the doctor’s office?
Dr. Gerberding: We don’t want vulnerable people flocking to emergency rooms, where infectious people are likely to be. It’s recommended that you not go in unless you know you’re ill and need immediate attention. Do call and discuss with a health professional what you are experiencing and take his or her advice. If your healthcare provider says to come in, put a mask on and go in. Some doctors also are advising patients to have a supply of Tamiflu at home, so that they already have the drug and don’t have to worry about how to get it or about going out to the drugstore if they’re not feeling well. But never take the drug without first consulting your doctor.
DHM: People with diabetes are often advised to get their annual flu shot. If a swine flu vaccine also is available, should a person get both vaccinations?
Dr. Gerberding: Absolutely. That’s an important point. Certainly you should get the annual flu shot. The timing on when to get the swine flu shot will largely depend on when the supply meets the demand, so patients will have to pay attention to what’s going on in the community and learn when they should get their vaccination.
—Marc Lichter
On Obesity & Diabetes
Dr. Julie Gerberding, director of the CDC from 2002 to 2009, has been a leader in the fight against the spread of AIDS, the battle against the bird flu epidemic, and more. Here, she offers her thoughts on what you can do to defeat America’s current epidemic—obesity and diabetes.
• Exercise. The mythology that you must be thin to be fit discourages people from being a little more active than they are. You don’t have to be athletic to be fit. You just need to move your muscles and get exercise through modest means—10 minutes of walking and other simple-to-do interventions, such as gardening. This level of exercise is very important for glucose control, cardiovascular endurance, and blood pressure control.
• Start Early. To help our children have a healthy start, petition to take vending machines out of schools, or to substitute healthier choices in the vending machines. Also, parents have to say no to fast foods. We need to create an environment that is not toxic to children and say, “Eat more fruits and vegetables.”
• Shop Smart. Reading food labels is important, but our current food-labeling practices need to be simplified. It’s very difficult to take in all the current information. What is a trans fat? What is a calorie? What is a gram? Most people can’t really visualize what a gram of something looks like. Yet, that’s the basis of our food-content information.
• Provide Support. The best intervention data for obesity prevention suggest that social networks and social engagement are much more powerful ways of achieving behavior modification than simply expecting an individual to do it alone. Healthcare providers, patients, and patients’ families should work together on motivational therapy when trying to make difficult changes in eating and physical fitness habits.
• Identify Cues. What causes you to eat on a binge? What’s your worst nightmare in terms of diet control? How can you avoid temptations, such as your favorite fast-food restaurant? These are really important things to know. Creating new behavior patterns that reduce the cues will help you to succeed.
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