My four year old son has had type 1 diabetes for two and a half years, and I’ve noticed that whenever he gets a cold or flu his symptoms appear much worse than that of my two year old daughter who doesn’t have diabetes. What is the reason for this? Is the fact that unstable blood sugars are the primary reason for increased susceptibility to viral infections? Are there any studies that suggest a correlation between diabetes and other diseases such as asthma?

In general terms, type�1 diabetes per se does not predispose to colds and flu. However, having said that, germs love sugar. So people with poorly controlled diabetes are at some increased risk for certain bacterial and yeast infections. (For example, women with uncontrolled diabetes often have increased numbers of vaginal yeast infections.)

On the other hand, an illness such as a cold can “stress” a person with diabetes to have higher glucose readings. Over-the-counter cough and cold medicines can also increase the blood glucose (slightly) if they have pseudoephedrine, flavored syrups, etc.

The number of colds a child gets is generally related to exposure to other ill persons and to time of the year. (There are more colds in winter because we tend to stay in closer proximity to other ill persons.) Overall, adults in the United States normally average two to four colds per year, and children average six to eight colds per year. In one 10 year study of illness in families, young children in nursery school averaged up to nine colds for the period of September through May. Illness rates decline in older children and reach adult levels in adolescence. Boys have slightly more colds than girls until adolescence, but after that the incidence is slightly higher in women, perhaps reflecting their greater exposure to young children.

What can you/your son do to limit colds? Practice good handwashing and good hygiene (and the people around him should practice this too!). Good diet and exercise are helpful, too.

I am not aware of studies indicating a link between diabetes and asthma. You are wise to consider that perhaps he doesn’t have a cold, but rather he might have allergies or his airway is being irritated by such things as secondhand cigarette smoke, etc.

DS