Tis the season of beso-beso and group hugs during endless reunions and karaoke nights! A lot of indoor human contact increases the transmission of viruses, which can cause the common cold.

The viruses are probably enjoying, too, their enhanced social life during the holidays. People with diabetes have to be extra careful in avoiding the common cold. It is easier to catch one if you have a compromised immune system, such as in those with uncontrolled diabetes. And, the duration and severity of the course of the cold may be a little worse for some. The immune system can further be compromised by stress, lack of sleep, and improper nutrition—all too common during the hustle and bustle of the season.

The common cold
The common cold (medically known as infectious nasopharyngitis) is the most common upper respiratory tract infection. More than 200 viruses can cause colds, the most commonly involved is the rhinovirus.

Symptoms usually show up about two days after a person becomes infected. Early signs of a cold are a sore, scratchy throat, sneezing, and a runny nose. Other symptoms that may occur later include headache, stuffy nose, watering eyes, hacking cough, chills, muscle aches, and general malaise (ill-feeling) lasting from 2 to 7 days.

Spreading the virus
Close personal and prolonged contact is necessary for the cold viruses to spread. The viruses must get into the nose where they can attach to the nasal membranes, inside which the viruses can multiply. Inhaling contaminated droplets produced when someone else coughs or sneezes is one way to catch a cold.

Cold viruses can remain infective even if they are outside the body for a few hours. You can catch a cold if you handle something that is contaminated with a cold virus and then stick your contaminated finger up your nose or rub your eyes.

People tend to blame cool temperatures for getting a cold rather than being in close contact with sick people. But it is not the cold temperature itself which triggers the infection, as more popularly thought. Cold, dry weather may remove moisture from the air which, in turn, can dry the mucous on the nasal membrane. Without a sufficient mucous layer covering these membranes, the nose becomes more susceptible to viruses.

Complications
For people with diabetes, a simple cold can lead to some complications, such as sinus or ear infections. Colds can also aggravate asthma and, in uncommon situations, increase the risk for lower respiratory tract infections or pneumonia.

Colds or any infection may worsen diabetes control by increasing sugar levels. Illness is a form of stress that rouses the body’s defenses. One effect is that the liver increases glucose production to provide more energy. At the same time, stress hormones are released which make cells more insulin resistant. The net result is blood sugar that is significantly higher during illness.

Patients with type 1 diabetes should watch out for extreme dehydration and the possibility of ketoacidosis during sick days.

Those with type 2 diabetes should likewise watch out for a state of severely high sugars and dehydration called hyperosmolar nonketotic coma.

What to do once a cold starts? The following are some food and fluid recommendations. Most will not cure a cold, but they may help a person deal better with the symptoms:
• Drinking plenty of fluids and getting lots of rest is still the best bit of advice to ease the discomfort of the common cold. Water is the best fluid and helps lubricate the mucous membranes.
*chicken soup does indeed help congestion and body aches. The hot steam from the soup may be its chief advantage, although laboratory studies have actually reported that ingredients in the soup may have anti-inflammatory effects. In fact, any hot beverage such as tea may have similar soothing effects from steam.
• Foods rich in vitamins A and C are widely recommended. They include oranges, grapes, dalandan, guava, kiwi, and tomatoes for vitamin C, and sweet potatoes, spinach, carrots and broccoli for vitamin A.

However, despite a few studies that suggest that very large doses of supplemental vitamin C may reduce the duration of a cold, most of the scientific evidence finds no benefit. In addition, a review of evidence suggests that taking large doses of vitamin C after the onset of cold symptoms does not improve the symptoms nor does it shorten the duration of the cold.

Medications
• Nasal-delivery decongestants are applied directly into the nasal passages with a spray, gel, drops, or vapors. Nasal forms work faster than oral decongestants and have fewer side effects. However, decongestants should be used only for conditions requiring short-term use, such as before air travel or for a single-allergy attack. Do not take them more than 3 days in a row. With prolonged use, nasal decongestants become ineffective and result in the so-callled rebound effect.

Oral decongestants come in many brands, the most common active ingredients are pseudoephedrine or phenylephrine. Oral decongestants have certain adverse effects, such as agitation and nervousness, drowsiness, changes in heart rate and blood pressure. People with diabetes may be at higher risk for these complications.

*Antibiotics don’t address viral infections. However, antibiotics may be required for upper respiratory tract infections only under certain situations, such as the following:
Patients, particularly small children or elderly people, who have medical conditions such as diabetes that put them at high risk for complications from any respiratory tract infection, may sometimes be given antibiotics.
Patients with severe sinusitis that does not clear up within 7-10 days
o Probable middle ear infections
o Patients with strep throat or severe sore throat that involves fever, swollen lymph nodes
o Paracetamol is useful to relieve headaches, fever, and achiness.

Diabetes Notes During Sick Days
Increase the frequency of blood sugar monitoring. As sugars increase, consider increasing the insulin doses and checking for ketones.

Be careful about stopping your medications. Even if you are not eating very well, sugars may increase, thus you will still need to continue insulin and some oral medications.

Be prepared. Ask for your doctor’s advice regarding sick days. Check with your doctor before taking any drug, herbal remedy, or dietary supplement when you’re ill.

Call your doctor or go to the hospital right away when: you develop signs and symptoms of ketoacidosis (such as stomach pain, vomiting, chest pain, difficulty breathing, feelings of weakness, sleepiness, fruity-smelling breath, blurry vision) and of dehydration (extreme thirst, dry mouth, cracked lips, sunken eyes, mental confusion, dry skin).

Prevention
Because colds are easily spread, everyone should always wash their hands before eating and after going outside. Ordinary soap is sufficient. Waterless hand cleaners that contain an alcohol-based gel are also effective for everyday use and may even kill cold viruses.

Antibacterial soaps add little protection, particularly against viruses. In fact, one study suggests that common liquid dish washing soaps are up to 100 times more effective than antibacterial soaps in killing respiratory syncytial virus (RSV), which is known to cause pneumonia. Wiping surfaces with a solution that contains one part bleach to 10 parts water is very effective in killing viruses.

Cover your own nose and mouth when sneezing or coughing, or wear a mask when truly sick. Or simply avoid human contact when you know you can be contagious.

Therefore, during this season, it may just be more fashionable to keep a no-contact stance , and sport a wave or a flying kiss when greeting friends or entering a party. Don’t forget to bring your own hand sanitizer.
Remember to give love (not colds) on Christmas day!

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