Effect of Influenza Vaccination in Preventing Laboratory-Confirmed Influenza Hospitalization in Patients With Diabetes Mellitus

Abstract Background People with diabetes are at high risk of severe influenza complications. The influenza vaccination effect among diabetic patients remains inconclusive. We estimated the average effect of influenza vaccination status in the current and prior seasons in preventing laboratory-confirmed influenza hospitalization in diabetic patients. Methods Patients attended in hospitals and primary healthcare centers with influenza-like illness were tested for influenza from the 2013–2014 to 2018–2019 seasons in Navarre, Spain. A test-negative case-control design in diabetic inpatients compared the influenza vaccination status in the current and 5 prior seasons between laboratory-confirmed influenza cases and negative controls. Vaccination status of influenza-confirmed cases was compared between diabetic inpatients and outpatients. Influenza vaccination effect was compared between diabetic patients and older (≥ 60 years) or chronic nondiabetic patients. Results Of 1670 diabetic inpatients tested, 569 (34%) were confirmed for influenza and 1101 were test-negative controls. The average effect in preventing influenza hospitalization was 46% (95% confidence interval [CI], 28%–59%) for current-season vaccination and 44% (95% CI, 20%–61%) for vaccination in prior seasons only in comparison to unvaccinated patients in the current and prior seasons. Among diabetic patients with confirmed influenza, current-season vaccination reduced the probability of hospitalization (adjusted odds ratio, 0.35; 95% CI, .15–.79). In diabetic patients, vaccination effect against influenza hospitalizations was not inferior to that in older or chronic nondiabetic patients. Conclusions On average, influenza vaccination of diabetic population reduced by around half the risk of influenza hospitalization. Vaccination in prior seasons maintained a notable protective effect. These results reinforce the recommendation of influenza vaccination for diabetic patients.

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Influenza vaccine effectiveness against hospitalization in the United States, 2019-2020

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa800 ◽

2020 ◽

Author(s):

Mark W Tenforde ◽

H Keipp Talbot ◽

Christopher H Trabue ◽

Manjusha Gaglani ◽

Tresa M McNeal ◽

...

Keyword(s):

United States ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Respiratory Illness ◽

The United States ◽

Vaccine Effectiveness ◽

Influenza Viruses ◽

Current Season ◽

Hospital Resources ◽

Negative Controls

Abstract Background Influenza causes significant morbidity and mortality and stresses hospital resources during periods of increased circulation. We evaluated the effectiveness of the 2019-2020 influenza vaccine against influenza-associated hospitalizations in the United States. Methods We included adults hospitalized with acute respiratory illness at 14 hospitals and tested for influenza viruses by reserve transcription polymerase chain reaction. Vaccine effectiveness (VE) was estimated by comparing the odds of current-season influenza vaccination in test-positive influenza cases versus test-negative controls, adjusting for confounders. VE was stratified by age and major circulating influenza types along with A(H1N1)pdm09 genetic subgroups. Results 3116 participants were included, including 18% (553) influenza-positive cases. Median age was 63 years. Sixty-seven percent (2079) received vaccination. Overall adjusted VE against influenza viruses was 41% (95% confidence interval [CI]: 27-52). VE against A(H1N1)pdm09 viruses was 40% (95% CI: 24-53) and 33% against B viruses (95% CI: 0-56). Of the two major A(H1N1)pdm09 subgroups (representing 90% of sequenced H1N1 viruses), VE against one group (5A+187A,189E) was 59% (95% CI: 34-75) whereas no significant VE was observed against the other group (5A+156K) [-1%, 95% CI: -61-37]. Conclusions In a primarily older population, influenza vaccination was associated with a 41% reduction in risk of hospitalized influenza illness.

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Adjuvant Supplementation with L-Carnitine in Diabetic Population and its effects on Lipid Parameters

10.53350/pjmhs211582017 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2017-2019

Author(s):

Rao Salman Aziz ◽

Usman Saeed ◽

Nasim Aslam Ghumman ◽

Muhammad Arshad ◽

Asif Sohail ◽

...

Keyword(s):

Diabetes Mellitus ◽

Triglyceride Level ◽

Clinical Care ◽

Diabetic Patients ◽

Healthy Population ◽

Patients With Diabetes ◽

Diabetic Population ◽

Large Discount ◽

The Impact ◽

Lipid Parameters

Background: Diabetes is a complicated disease requires continuous clinical care, to govern blood sugar. Aim: To decides the impact of management of L carentin to diabetics at the lipid profile. Methods: This study turned into performed on 120 diabetic Patients had been decided on from endocrinology and diabetes, inside decided on standards. The Patients distributed into three Strata (1st Strata of healthy population and two Strata of patients with diabetes who were on metformin and glibenclamide, one Strata took a L carnitine in a dose of 1000 mg TDS and a Strata dealing with a placebo for a period of ninety days). Results: It is observed those who are on Lcarnitine, confirmed a large discount (p <0.05) with inside the triglyceride level, at the same time as no large adjustments had been located withinside the level of cholesterol and HDL and LDL. Conclusion: These study outcomes that management of L carentin improved profile of lipid in type-2diabetic Patients. Keyword: Dyslipidemia, Diabetes mellitus (DM), l-carnitine (LC).

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Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives

BioMed Research International ◽

10.1155/2018/8927281 ◽

2018 ◽

Vol 2018 ◽

pp. 1-13 ◽

Cited By ~ 3

Author(s):

Andrea Igoren Guaricci ◽

Delia De Santis ◽

Mariangela Carbone ◽

Giuseppe Muscogiuri ◽

Marco Guglielmo ◽

...

Keyword(s):

Cardiac Computed Tomography ◽

Lessons Learned ◽

Diabetic Patients ◽

Prognostic Impact ◽

Stress Tests ◽

Noninvasive Technique ◽

Cardiac Computed Tomography Angiography ◽

Coronary Ct ◽

Patients With Diabetes ◽

Diabetic Population

The prognostic impact of diabetes mellitus (DM) on cardiovascular outcomes is well known. As a consequence of previous studies showing the high incidence of coronary artery disease (CAD) in diabetic patients and the relatively poor outcome compared to nondiabetic populations, DM is considered as CAD equivalent which means that diabetic patients are labeled as asymptomatic individuals at high cardiovascular risk. Lessons learned from the analysis of prognostic studies over the past decade have challenged this dogma and now support the idea that diabetic population is not uniformly distributed in the highest risk box. Detecting CAD in asymptomatic high risk individuals is controversial and, what is more, in patients with diabetes is challenging, and that is why the reliability of traditional cardiac stress tests for detecting myocardial ischemia is limited. Cardiac computed tomography angiography (CCTA) represents an emerging noninvasive technique able to explore the atherosclerotic involvement of the coronary arteries and, thus, to distinguish different risk categories tailoring this evaluation on each patient. The aim of the review is to provide a wide overview on the clinical meaning of CCTA in this field and to integrate the anatomical information with a reliable therapeutic approach.

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Update on RAAS Modulation for the Treatment of Diabetic Cardiovascular Disease

Journal of Diabetes Research ◽

10.1155/2016/8917578 ◽

2016 ◽

Vol 2016 ◽

pp. 1-17 ◽

Cited By ~ 23

Author(s):

Stella Bernardi ◽

Andrea Michelli ◽

Giulia Zuolo ◽

Riccardo Candido ◽

Bruno Fabris

Keyword(s):

Cardiovascular Disease ◽

Diabetic Patients ◽

Paradigm Shifts ◽

Angiotensin Ii Receptor ◽

First Line ◽

Chronic Complications ◽

First Line Therapy ◽

Patients With Diabetes ◽

Receptor Blockers ◽

Diabetic Population

Since the advent of insulin, the improvements in diabetes detection and the therapies to treat hyperglycemia have reduced the mortality of acute metabolic emergencies, such that today chronic complications are the major cause of morbidity and mortality among diabetic patients. More than half of the mortality that is seen in the diabetic population can be ascribed to cardiovascular disease (CVD), which includes not only myocardial infarction due to premature atherosclerosis but also diabetic cardiomyopathy. The importance of renin-angiotensin-aldosterone system (RAAS) antagonism in the prevention of diabetic CVD has demonstrated the key role that the RAAS plays in diabetic CVD onset and development. Today, ACE inhibitors and angiotensin II receptor blockers represent the first line therapy for primary and secondary CVD prevention in patients with diabetes. Recent research has uncovered new dimensions of the RAAS and, therefore, new potential therapeutic targets against diabetic CVD. Here we describe the timeline of paradigm shifts in RAAS understanding, how diabetes modifies the RAAS, and what new parts of the RAAS pathway could be targeted in order to achieve RAAS modulation against diabetic CVD.

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Influence of Prior Influenza Vaccination on Current Influenza Vaccine Effectiveness in Children Aged 1 to 5 Years

Vaccines ◽

10.3390/vaccines9121447 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1447

Author(s):

Kazuhiro Matsumoto ◽

Wakaba Fukushima ◽

Saeko Morikawa ◽

Masashi Fujioka ◽

Tohru Matsushita ◽

...

Keyword(s):

Influenza Vaccination ◽

Reference Group ◽

Vaccination Strategy ◽

Negative Influence ◽

Vaccine Effectiveness ◽

Vaccination Status ◽

Current Season ◽

Vaccination Rates ◽

Vaccination History ◽

Group 2

Background: Although annual influenza vaccination is an important strategy used to prevent influenza-related morbidity and mortality, some studies have reported the negative influence of prior vaccination on vaccine effectiveness (VE) for current seasons. Currently, the influence of prior vaccination is not conclusive, especially in children. Methods: We evaluated the association between current-season VE and prior season vaccination using a test-negative design in children aged 1–5 years presenting at nine outpatient clinics in Japan during the 2016/17 and 2017/18 influenza seasons. Children with influenza-like illness were enrolled prospectively and tested for influenza using real-time RT-PCR. Their recent vaccination history was categorized into six groups according to current vaccination doses (0/1/2) and prior vaccination status (unvaccinated = 0 doses/vaccinated = 1 dose or 2 doses): (1) 0 doses in the current season and unvaccinated in prior seasons (reference group); (2) 0 doses in the current season and vaccinated in a prior season; (3) 1 dose in the current season and unvaccinated in a prior season; (4) 1 dose in the current season and vaccinated in a prior season; (5) 2 doses in the current season and unvaccinated in a prior season, and (6) 2 doses in the current season and vaccinated in a prior season. Results: A total of 799 cases and 1196 controls were analyzed. The median age of the subjects was 3 years, and the proportion of males was 54%. Overall, the vaccination rates (any vaccination in the current season) in the cases and controls were 36% and 53%, respectively. The VEs of the groups were: (2) 29% (95% confidence interval: −25% to 59%); (3) 53% (6% to 76%); (4) 70% (45% to 83%); (5) 56% (32% to 72%), and (6) 61% (42% to 73%). The one- and two-dose VEs of the current season were significant regardless of prior vaccination status. The results did not differ when stratified by influenza subtype/lineage. Conclusion: Prior vaccination did not attenuate the current-season VE in children aged 1 to 5 years, supporting the annual vaccination strategy.

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2731. Does Last Season’s Influenza Vaccination Affect Current Season’s Vaccine Effectiveness in Young Children?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2409 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S961-S961

Author(s):

Suchitra Rao ◽

Molly Lamb ◽

Angela Moss ◽

Edwin J Asturias

Keyword(s):

Medical Condition ◽

Vaccine Effectiveness ◽

Vaccination Status ◽

Urgent Care ◽

Control Analysis ◽

Current Season ◽

Logistic Regression Models ◽

Negative Case ◽

Influenza Illness ◽

Case Control Analysis

Abstract Background We evaluated influenza VE over two consecutive years vs. the current season against influenza illness during two H3N2-predominant seasons in children receiving care at emergency/urgent care (ED/UC) facilities in metropolitan Colorado. Methods We conducted a test-negative case–control analysis of 1478 children aged 6 months to 8 years enrolled at Children’s Hospital Colorado ED/UC with influenza like illness during the 2016–2017 and 2017–2018 influenza seasons. The primary outcome was PCR-confirmed influenza and vaccination status was confirmed using electronic medical record and parental interviews. Vaccination status was defined as completely vaccinated (all doses of influenza vaccine according to child’s age); partially or not vaccinated children were defined as unvaccinated. Multivariable logistic regression models adjusted for high-risk medical condition, age, race and insurance status were used to calculate odds ratios (OR) and 95% confidence intervals. Vaccine effectiveness was calculated as (1 − OR) × 100. Results Of the 1224 (82.8%) children enrolled in the study with known vaccination status for both seasons, 361 (29%) tested positive for influenza. Overall, VE against influenza was 49% (95% CI, 33–61%) after adjusting for other covariates in the model. VE did not differ significantly between those vaccinated in both seasons and those vaccinated in only the current season (VE 69%, 95% CI 41–115) (Table 1). Conclusion Our estimates of influenza VE for two predominantly H3N2-influenza seasons in Colorado are comparable to the CDC -VE for children 6 months to 8 years. VE against ED or UC-attended influenza illness in children did not vary significantly by prior seasons’ vaccination status. Disclosures All authors: No reported disclosures.

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Glaucoma in diabetic patients and the need for further research

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20204255 ◽

2020 ◽

Vol 8 (10) ◽

pp. 3703

Author(s):

Omyma Abbas Banaga Salih ◽

Zaid Al Hamadani ◽

Bayan Alemrayat ◽

AlAnoud AlFehaidi ◽

Ehab Hamed

Keyword(s):

At Risk ◽

Systematic Reviews ◽

Pooled Analysis ◽

Future Research ◽

Diabetic Patients ◽

Positive Side ◽

Increased Risk ◽

Study Results ◽

Patients With Diabetes ◽

Diabetic Population

Glaucoma is considered the leading cause of irreversible blindness worldwide. Patients with diabetes are at risk of different eye complications, mainly retinopathy. Patients with diabetes are also at risk of developing cataract, uveitis and glaucoma. Three systematic reviews examined the associations between diabetes and glaucoma. Pooled analysis from those studies reported different OR 1.37, (95% CI=0.72-2.02), OR=1.36, (95% CI=1.25-1.50) and OR=1.48, (95% CI=1.29-1.71). Although the results seem close and suggest an increased risk in the diabetic population, the systematic reviews report significant heterogenicity and come short in explaining causality. Indeed, in one systematic review where 3 out of 7 studies suggested a non-significant association, the results were skewed to the positive side with a one-record based study that had a population size exceeding 2 million patients, while the rest of the studies had collectively 100 thousand patients. In our view, a case control study design that combines the patient surveys and electronic medical records ensure accurate data and more valid study results to validate or refute the association. This short communication article discusses the condition associations, theories for increased risk in the diabetic population and implications for future research.

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PNEUMONIA AND MORTALITY RISK: STUDY ON DIABETIC AND NON-DIABETIC PATIENTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2020.v13i8.37267 ◽

2020 ◽

pp. 188-191

Author(s):

NARMADHA MP ◽

NIKHNA JAYAN ◽

RON JOHNY

Keyword(s):

Pneumonia Severity Index ◽

Severity Index ◽

Underlying Disease ◽

Resistant Bacteria ◽

Diabetic Patients ◽

Antibiotic Resistant ◽

Patients With Diabetes ◽

Diabetic Population ◽

Group 2

Objective: Pneumonia, a frequent coexistent of diabetes, is an important cause of morbidity and mortality in diabetes. The diabetic population is not only prone to pulmonary infection but it is also prone to different comorbidity and complication. Therefore, the aim of the study was to assess and compare mortality in diabetic pneumonia and non-diabetic pneumonia group. Methods: This was a prospective case–control study conducted in two hospitals which included 76 patients with Group 1 (patients with diabetics) and 70 patients with Group 2 (patients who are non-diabetics). Results: Among 146 patients, mortality in diabetics was 5.47% in comparison with non-diabetics 4.10%. Patients in the diabetic group were significantly (p=0.044) more among pneumonia severity index (PSI) Class IV–V (9.21%) than PSI Class I-III (1.31%). Most of the patients had predisposing condition or underlying disease, hypertension (87.50% vs. 50%), pulmonary (37.50% vs. 83.33%), neurological (37.50% vs. 83.33%), and renal disease (37.5% in diabetic). The common complication in both groups was pleural effusion (50%) and septic shock (25%). Gram-negative bacteria (62.5% vs. 33.33%) and drug-resistant pathogens score (87.5% vs. 66.66%) were more prevalent in both groups. Conclusion: Our study reveals that poor long-term glycemic control among patients with diabetes clearly increases the risk of hospitalization and mortality. In non-diabetic pneumonia patients, antibiotic-resistant bacteria and preexisting pulmonary disease act as a predictor for mortality.

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Diabetic COVID -19 Patients are prone to Respiratory Distress Syndrome as compared to Non-Diabetic COVID -19 Patients.

10.53350/pjmhs2115123271 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3271-3272

Author(s):

Ali Raza Memon ◽

Muhammad Akram ◽

Farheen Shaikh ◽

Muhammad Zohaib Shaikh ◽

Rizwan Ahmed Memon ◽

...

Keyword(s):

Diabetes Mellitus ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Medical Center ◽

Serum Lactate ◽

Serum Lactate Dehydrogenase ◽

Diabetic Patients ◽

Patients With Diabetes ◽

Diabetic Population

Background: COVID-19 is the alarming problem for all over the world due to its fast spread infection mode and uncertainty in mortality rate. The diabetic population is prone for comorbidity with COVID-19 due to injurious fashion develops in respiratory system. Aim: To compare the serum Lactate dehydrogenase levels in diabetic patients with COVID-19 & non diabetic patients with COVID-19. Methodology: This comparative study was done at Ali medical center Hala New District Matiari Sindh. 42 diabetic & non diabetic clinically suspected cases COVID -19 with fever, cough, shortness of breath, non-pneumonic opacities on digital X.ray with raised TLC, ESR & CRP. The data analyzed for significance on SPSS 19 by applying student t test. Results: The serum LDH levels was significantly raised (p<0.001) in group A contained COVID-19 patients with diabetes as compared to COVID-19 patients with no diabetes mellitus. Conclusion: COVID -19 diabetic population will be more prone to develop the respiratory complications. Keywords: COVID-19, Serum LDH, Diabetes Mellitus, Respiratory Distress Syndrome.

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Influenza vaccination coverage in patients with diabetes mellitus afferent to an Italian hospital

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.037 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

G Cocciolo ◽

S Salvati ◽

A Allora ◽

C Molinari ◽

A Burini ◽

...

Keyword(s):

Influenza Vaccination ◽

Vaccination Coverage ◽

Standards Of Care ◽

Healthcare Personnel ◽

Diabetic Patients ◽

Diabetes Clinic ◽

Vaccine Preventable Diseases ◽

Care Givers ◽

Increased Risk ◽

Patients With Diabetes

Abstract Background Patients with type 1 (T1DM) and type 2 (T2DM) diabetes are at increased risk of vaccine-preventable diseases and their complications. The National Vaccinal Prevention Plan 2017-2019 includes specific recommendations for patients with diabetes, which in 2018 have been included in the standards of care of the Italian Diabetes Society (SID) and Italian Association of Clinical Diabetologists (AMD). Methods Adult diabetic patients attending the Diabetes clinic at the San Raffaele Hospital, a large teaching hospital in Milan, Italy, were surveyed with a questionnaire to investigate self-reported vaccinal history, knowledge, attitudes and practice on the recommended vaccinations, vaccinal hesitancy and information sources on the topic. Results Between May 16 and November 11, 2019 N = 222 T1DM and N = 57 T2DM patients were enrolled. 25.2% of T1DM and 26.3% of T2DM patients did get vaccinated annually against the flu in the past 3 year. 85.0% of T2DM patients were vaccinated at the General Practitioner's (GP) clinic, while 54.9% of T1DM patients were vaccinated by their GP and 24.4% from territorial vaccinal clinics. 54.5% of T1DM and 50.0% of T2DM patients chose not to be vaccinated because they didn't consider the vaccine useful, while the second most common reason was that they have not been advised by healthcare personnel. Conclusions We documented a low coverage and knowledge about influenza vaccination. Patients with diabetes trusted information and advice of diabetologists and GPs about vaccination and claimed that they would be more likely to vaccinate if vaccination were offered in the diabetes clinic. Implementing training programs for professionals and educational campaigns for patients with diabetes may improve vaccinal coverage. Key messages Vaccination coverage in T1DM and T2DM patients is low due to vaccination hesitancy. A strong action from care givers, in order to raise vaccination awareness in this at-risk population, is needed.

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