Adults With Diabetes Need a Flu Shot: Experts

Large Canadian study finds people with diabetes are more likely to get sick from flu, be hospitalized

Friday, January 24, 2014

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FRIDAY, Jan. 24, 2014 (HealthDay News) -- Adults 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 hospitalized for flu.

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 hospitalized associated with influenza compared to similar-aged adults without diabetes," said lead researcher Jeffrey Johnson.

"This increased risk is small (6 percent), 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.

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 work."

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 said.

The report was published Jan. 24 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 said.

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 said.

These complications include pneumonia, hospitalization, 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 percent of people with diabetes were vaccinated, it would still be cost-effective in terms of fewer hospitalizations 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, N.Y., 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.

SOURCES: Jeffrey Johnson, Ph.D., director, Alliance for Canadian Health Outcomes Research in Diabetes, University of Alberta, Canada; Bruce Hirsch, M.D., attending physician, division of infectious diseases, North Shore University Hospital, Manhasset, N.Y.; Spyros Mezitis, M.D., endocrinologist, Lenox Hill Hospital, New York City; William Schaffner, M.D., professor and chairman, department of preventive medicine, Vanderbilt University School of Medicine, Nashville, Tenn.; Jan. 24, 2014, Diabetologia

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