Care recommendations
Influenza and Pneumococcal Pneumonia vaccinations
People with diabetes are more at risk of complications arising as a result of infections such as influenza and pneumococcal pneumonia. Elevated blood glucose levels, as a response to infection, can lead to uncontrolled diabetes and the potential danger of diabetic ketoacidosis (DKA) or hyperosmolar non ketotic coma (HONK), both of which can be fatal if left untreated.
Vaccinations exist for influenza and pneumococcal pneumonia, which are proven to be safe and effective in preventing, or lessening the severity of, the infection and are suitable for use in diabetes.
The benefits of vaccination are less well demonstrated in those under the age of 60. However, given the increased rates of hospital admissions with and deaths from DKA during an influenza epidemic, for example, vaccination for all people with diabetes could be appropriate, especially if there are other risk factors present, particularly cardiovascular or respiratory disease.
In light of these facts. Diabetes UK would recommend that all people with diabetes should be offered vaccination against influenza and pneumococcal pneumonia. This is especially true for those over the age of 60 (for influenza) and 65 (for pneumococcal pneumonia) or for those who are younger with other risk factors.
Given the current low level of vaccination uptake, even in high-risk groups, strategies to ensure effective coverage need to be developed. Consideration will therefore be given to publicising the availability of appropriate vaccinations to people with diabetes in the autumn edition of Balance and Diabetes Update and in the Diabetes UK leaflet Coping with diabetes when you are ill.
2006