Study confirms diabetics are more vulnerable to flu

by Barbara Hewitt on January 29, 2014

Working age people with diabetes do face an increased risk from flu and should be vaccinated, new research has found.

Some major organisations, such as the American Diabetes Association and the Canadian Diabetes Association already recommend vaccination for diabetics but until now there was little evidence to back this policy.


Research showed adults with diabetes had a 6% greater increase in all cause hospitalisations associated with flu compared to adults without diabetes

Other bodies in countries such as the UK and Australia also recommend the flu jab for diabetics but in many it is only those aged 65 and over who are targeted in flu vaccination programmes.

Now a new study by a team for the School of Public Health at the University of Alberta in Edmonton, Canada, confirms the recommendation and suggests that all diabetics aged 18 and over should be offered the flu jab.

Their report says that previous studies to assess the risk of flu in adults with diabetes have had various methodological problems, so their aim was to do a new study to provide evidence on the recommendation to give the vaccine to adults with diabetes.

Using data from Manitoba, Canada, from 2000 to 2008, the team identified all working age adults with diabetes and matched with up to two non-diabetic controls. They looked at how often they visited the doctor and whether they were ever in hospital for flu related illness.

‘Our observation that working age adults with diabetes experience a greater burden of influenza than similar non-diabetic adults provides a clinical justification for targeted anti influenza interventions. Identifying particular interventions and evaluating their effectiveness in this population are questions for further research,’ the research study says.

Overall details were examined for 163,202 people with a median age 52.5 years, of whom just under half, 48.5%, were women. The data showed that adults with diabetes had more co-morbidities and received flu vaccinations more often than those without diabetes. After adjusting for these differences, adults with diabetes had a 6% greater increase in all cause hospitalisations associated with flu compared to adults without diabetes.

This translates to a total additional burden of 54 hospitalisations across Manitoba in working age adults due to their diabetes. No statistically significant differences were detected in flu attributable rates of the other outcomes such as flu like illness or pneumonia and flu.

The team points out that even if the vaccination effectiveness were as low as 20%, it could be cost effective to vaccinate adults with diabetes to avoid the costs of hospitalisation with flu. They add that the individual situation in different countries could vary depending on local practices and costs.

‘Vaccination guidelines indirectly single out working age adults with diabetes for routine vaccination. We have demonstrated an increased burden of influenza in this population. Randomised trials are needed to confirm actual vaccination effectiveness in this group,’ the research explained.

‘Formal economic studies are also required, to ascertain the extent to which identifying diabetes as a high risk indication for vaccination may mitigate the use of healthcare resources and costs associated with influenza. Until such studies are available, our work represents the strongest current evidence highlighting the burden of influenza, and the potential benefits of influenza vaccination, in diabetic adults,’ it adds.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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