Experts say people with diabetes should keep their vaccinations up to date because ailments such as the flu can cause serious complications.
It’s back. The start of the flu season, and that leaves people with a decision about whether to get this year’s vaccine.
For people with diabetes, that question is even more crucial.
People with type 1 or type 2 diabetes have an increased risk of contracting seasonal viruses, such as the flu, and being hospitalized while fighting the disease.
For those struggling with obesity, as many people with diabetes do, infections such as whooping cough or the flu are especially dangerous.
For example, a virus that might produce a mild illness in a lean person could tip an obese person with restrictive lung physiology into overt respiratory failure.
“Pertussis — or any respiratory illness — could be worse for severely obese people who may have comorbidities such as sleep apnea and obesity hypoventilation syndrome,” Dr. Eric Sodicoff, author of the Phoenixville Nutrition Guide, told Healthline.
The American Association of Diabetes Educators (AADE) emphasizes that no matter how well-managed your diabetes may be, every eligible person with diabetes should get vaccinated.
“People with diabetes may be at higher risk of getting certain diseases and also serious problems from diseases that could’ve been prevented with vaccines,” Evan Sisson, PharmD, MHA, CDE, FAADE, and associate professor in the Department of Pharmacotherapy & Outcomes Science at Virginia Commonwealth’ University’s School of Pharmacy, told Healthline. “Everyone should know what vaccines they need to protect themselves and discuss with their doctor whether they are up to date with the vaccines.”
Experts say vaccines, such as the flu shot, will most likely not give you the illness they are designed to prevent because they contain a dead version of the virus.
Instead, the vaccines help your immune system prepare the antibodies that will fight off the virus if you come into contact with it.
Since type 1 diabetes is an autoimmune disease, the immune system of someone with the ailment has already been compromised, which means its ability to successfully fight off a virus is less likely.
“People with type I diabetes have immune systems that are less vigilant than in normal people,” Dr. Len Horovitz, a pulmonary specialist from Lenox Hill Hospital in New York City, told Healthline.
“The infection risk in diabetes, whether viral or bacterial, is well known,” Horovitz explained. “In addition, high blood sugar levels [in type 1 or type 2 diabetes] promote infection on their own.”
Horovitz adds that people with diabetes are also more susceptible to pneumococcal pneumonia, increasing the value of vaccines such as Prevnar and Pneumovax.
For patients specifically with type 1 diabetes, a simple bout of vomiting, fever and/or virus-induced dehydration can easily lead to diabetic ketoacidosis (DKA).
DKA, according to the CDC, is “an emergency condition in which extremely high blood glucose levels, along with a severe lack of insulin, result in the breakdown of body fat for energy, and an accumulation of ketones in the blood and urine. Signs of DKA are nausea and vomiting, stomach pain, fruity breath odor, and rapid breathing. Untreated DKA can lead to coma and death.”
Even with previously well-managed blood sugar levels, the addition of the flu virus within a body of a person with type 1 diabetes exacerbates its ability to manage even basic aspects of homeostasis.
A person with type 1 diabetes who is concerned they may have the flu should monitor blood sugar levels with extra diligence. They should get to an emergency room quickly to receive intravenous fluids (saline, electrolytes, and sometimes insulin and glucose) if blood sugars seem resistant to insulin doses, at the first sign of vomiting, and if ketone levels on urine or blood test-strips become moderate to large.
People with type 1 and type 2 diabetes are also twice as likely to die of a complication related to the flu, according to a 2018 study from the Indian Journal of Endocrinology and Metabolism.
Approximately 80,000 people die each year from the flu, including otherwise healthy children.
Getting the flu shot and other vaccines like Tdap (for tetanus, diphtheria, and whooping cough) not only protects you, it protects those unable to get vaccinated, like babies under 6 months, and people with severe allergies to vaccine ingredients.
Experts say the flu shot can’t give you the flu because it contains a dead virus. Instead, it simply helps your body prepare your immune system with the antibodies that will help fight off the flu if you come in contact with the virus.
“AADE has partnered with the Centers for Disease Control and Prevention (CDC) to spread the word on vaccines that are important for people living with diabetes,” explains a recent press release from the AADE.
These vaccines include:
- Influenza vaccine: “A flu shot is the single best way to protect against seasonal flu. Flu puts people with diabetes at high risk for health complications such as increased blood glucose levels. The illness can also lead to more serious sicknesses such as pneumonia, bronchitis, sinus infections, and ear infections, often resulting in hospitalization, and sometimes even death.”
- “People should get a flu vaccine annually, and the vaccines are already available this year.”
- Tdap vaccine: “The Tdap vaccine protects against three serious diseases caused by bacteria: tetanus, diphtheria and pertussis, or whooping cough.”
- “People should get the Tdap vaccine every 10 years.”
- Zoster vaccine: “The zoster vaccine reduces the risk of developing shingles and PHN, serious illnesses for unvaccinated people as they age.”
- “People age 50 and older should get the Zoster vaccine.”
- Pneumococcal vaccine: “People with diabetes are at an increased risk for death from pneumococcal infections, which can include infections of the lungs, blood, ear, and lining of the brain and spinal cord.”
- “People with diabetes should get the pneumococcal vaccine once before the age of 65 and twice more after.”
- Hepatitis B vaccine: “Since hepatitis B can be spread via shared blood glucose meters, finger-stick devices, and other diabetes care equipment, it’s critical that people with diabetes receive the vaccine.”
- “The hepatitis B vaccine should be given to people who are younger than 60. People age 60 or older should ask their doctors about the vaccine.”
Diseases such as the flu can cause serious complications for people with diabetes or for those who are obese.
People with type 1 and type 2 diabetes are also twice as likely to die of a complication related to the flu, explains a 2018 study from the Indian Journal of Endocrinology and Metabolism.
For these reasons, it’s important for people with diabetes to get vaccinated against the flu as well as other diseases.
For more information about diabetes and vaccines, visit: AADE vaccine recommendations.