with diabetes are vulnerable to flu and its complications, experts say. Now
a large new study finds they're also at higher risk of being hospitalised for
The study, which focused on people aged 18 to 64, provides support for
guidelines advising people with diabetes to get a
flu shot, the Canadian researchers said.
"Working-age adults with diabetes appear to have an increased risk of
being hospitalised associated with influenza compared to similar-aged adults
without diabetes," said lead researcher Jeffrey Johnson.
More health problems
"This increased risk is small (6%), but nonetheless is justification
for targeting adults with diabetes to get vaccinated,"
said Johnson, director of the Alliance for Canadian Health Outcomes Research in
Diabetes at the University of Alberta.
The American Diabetes Association, the Canadian Diabetes Association and
government agencies in both countries recommend flu shots for people with
diabetes, Johnson said.
To look at the effect of flu shots, Johnson and his colleagues used data on
more than 160 000 men and women in Manitoba province from 2000 to 2008. Their
average age was about 51.
People with diabetes tended to have more health problems than people without
diabetes, the researchers found.
People with diabetes were more likely to get flu shots than people without
the disease, the study showed. Even so, people with diabetes had 6 percent
greater odds of being hospitalized for flu than those without diabetes.
Little harm in getting vaccinated
For Johnson, one important question remains unanswered: Just how effective
is the vaccine in preventing people with diabetes from getting the flu?
"That piece of evidence is still not clear, and was not part of this
study," he said. "The current evidence of this is very weak [and has]
many limitations, so we actually don't know how well these vaccinations
Nonetheless, there is relatively little harm in getting vaccinated, Johnson
said. These findings provide support for the current guidelines and for getting
an annual influenza vaccination, especially for adults living with diabetes, he
The report was published in the journal Diabetologia.
Dr Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York
City, said people with diabetes have weakened immune systems. "Diabetics
are not as strong in defending themselves against disease, and that's why they
need to get the flu vaccine," he said.
Flu shots are recommended for the general public as well, another expert
Risk for complications
The recommendation in the United States is that everyone 6 months and older
get a flu shot, said Dr William Schaffner, chairman of the department of
preventive medicine at the Vanderbilt University School of Medicine.
This is especially important for people at risk for complications from flu,
including people with chronic
diseases such as diabetes, heart or lung disease, and pregnant women, he
These complications include pneumonia,
hospitalisation, and dying of the disease or its complications, Schaffner said.
"This study reaffirms what we should be doing and are not doing
optimally yet," Schaffner said. "We are not vaccinating the majority
of people with diabetes."
Based on their findings, Johnson's team calculated that even if only 20% of
people with diabetes were vaccinated, it would still be cost-effective in terms
of fewer hospitalisations for flu. They cautioned, however, that this cost
benefit might only apply in Canada and may differ in other areas.
Dr Bruce Hirsch, an attending physician in the division of infectious
diseases at North Shore University Hospital in Manhasset, New York, said, "Not
only should a person with diabetes get a flu shot, but people who live with
that person should also be vaccinated."
"This prevents the possibility of infecting that individual, and
surrounds a vulnerable person with additional protection," he said.
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