Why is vaccination needed for diabetics?

Individuals with diabetes are at a three times higher risk of death due to pneumonia-related complications. It has been observed that influenza increases complications due to coronary artery dis-ease in diabetics. Diabetics are 2 to 4 times more prone to cardiovascular illness. Influenza further complicates it. Uncontrolled diabetics with Half of more than 9 % are at increased risk of pneumonia-related hospitalization.

What is the role of vaccination in diabetics?

A prospective study has concluded with the findings that vaccination against pneumonia with 23 talent pneumococcal vaccine and influenza vaccine in adults above 65 years or older leads to substantial health benefits and leads to reduced deaths from all causes in this age group.

What about Hepatitis B infection?

This is an important and dangerous infection. Due to multiple pricks for blood glucose estimation and insulin administration, Hepatitis B infection can be appropriately preventable. Single-use needles and cleaning of blood glucose monitors if being used by more than one individual are suggested.

What about vaccination against Hepatitis B?

The effectiveness of the hepatitis B vaccine reduces with age. The main considerations for the administration of vaccines in adults include patients’ likelihood of acquiring hepatitis B. Patients with chronic kidney disorders and on hemodialysis should be vaccinated. Hepatitis B vaccination consists of 3 doses of vaccine administered intra-muscularly at 0,1 and 6 months. The schedule and dose may vary according to the person’s health profile.

What about Herpes zoster vaccination?

Diabetes is a significant risk factor for herpes zoster infection. Diabetes is a significant inflammatory state and causes a reduction in immunity. In herpes zoster infection, there is reactivation of the varicella-zoster virus causing herpes zoster. Neuralgic pains in diabetics are more severe and persistent. Zoster vaccine can be given along with pneumonia vaccination. Two doses of herpes vaccine are given 2 months apart.

In diabetes, people of all age groups are vulnerable to infectious diseases like pneumonia and influenza. Certain underlying medical conditions like Diabetes, asthma, COPD, and cardiovascular illness aggravate the risk. Preventable infections have become important complications of diabetes. Diabetics should be vaccinated against these infections to prevent acute illness and subsequent inconveniences.

What about vaccination against Coronavirus?

Most of the adult population has already received 2 doses. However, a booster dose is extremely significant in diabetics. Diabetics are at increased risk to have COVID-19 infection and have increased complication rates.

What is the status of vaccination in diabetics worldwide?

In advanced countries, the overall vaccination rate is about 70%. In our country, inspired by the increased prevalence of diabetes and greater infection rates, the vaccination guidelines for diabetics are hardly followed.

What are the vaccines suggested for diabetics, particularly in those above 60 years of age group?

Hepatitis B vaccine, HPV vaccine particularly for those below 26 years, annual influenza vaccine, Prevnar and Pnemuvax vaccine against bacterial pneumonia. All adults and pregnant women with diabetes should have an extra dose of TDAP vaccine. All diabetics above the age of 50 years should have 2 doses 2 months apart from the Zoster vaccine.

How to improve vaccination in a diabetic?

Greater awareness amongst primary care Physicians and diabetics about vaccine-preventable diseases is necessary. Setting up vaccination clinics, coverage by mass media and education about vaccination in diabetics in offices, colleges and at public utilities is suggested. Besides good control of blood glucose by way of HBA1C measurement, normalisation of blood pressure and cholesterol and regular exercises and weight management, there are certain unmet needs of diabetics still prevalent in large numbers of diabetics in India. This includes preventable infections like influenza, pneumonia, herpes. Poster, hepatitis B, and a few others. A simple health intervention like disease pre-venting vaccination will go a long way in mitigating some miseries in diabetics.

Categories : Diabetes

Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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