Vaccines and Diabetes: Why It’s Important for Diabetic Residents to Stay Up-to-date

When working with residents who have chronic diseases, such as diabetes, it’s important for long-term care pharmacy providers to consider all facets of care, including vaccinations. So what’s the connection between vaccines and diabetes? There are two very important reasons why vaccines have a high level of importance for residents with diabetes—both Type 1 and Type 2. First, even if tightly controlled, diabetes has an effect on the immune system where it is harder for the body to fight infections. This increases the potential likelihood for infections including those that may be preventable with a vaccination. Secondly, residents with diabetes are at risk for more severe complications compared to residents who do not have diabetes. For example, some infections such as influenza can increase blood glucose levels to dangerously high levels. People with diabetes also have an increased risk of death from pneumonia and bacteremia.   The CDC has identified five vaccinations that should be carefully considered for administration in residents with diabetes. They include the influenza, pneumococcal, hepatitis B, zoster, and Tdap vaccines. Let’s review some of the key reasons why these vaccines should receive special consideration from your post-acute care pharmacy team and the team at large for residents with diabetes.

Vaccines and Diabetes: Influenza (Flu)

The flu virus can complicate diabetes control by altering the body’s metabolism and by affecting the desire to eat, thus resulting in the potential for significant increases or decreases in blood sugar levels. In addition, the flu is the hardest on individuals age 65 and older, those who have underlying conditions, and those with weakened immune systems. Individuals who reside in Skilled Nursing Facilities and those with diabetes are two groups of people who are at high risk for developing flu-related complications such as pneumonia, bronchitis, and sinus or ear infections.   While receiving the flu vaccine may not provide absolute protection against the flu, those who receive the vaccine and then get the flu are generally less sick and sick for a shorter duration of time.   Annual flu vaccines are already recommended for all people over age 6 months, but should be considered even more so by residents with diabetes.

Vaccines and Diabetes: Pneumococcal (Pneumonia)

Individuals with diabetes have been shown to have a three times higher risk for contracting pneumonia compared to healthy adults the same age. This is coupled with the fact that a diabetic resident is also predisposed to severe complications from pneumonia.   The guidelines for pneumococcal vaccination have recently changed with individuals over age 65 now being recommended to receive both the pneumococcal conjugate vaccine (Prevnar 13) and pneumococcal polysaccharide vaccine (Pneumovax).   Due to the recent guideline changes coupled with the potential risks for diabetic residents, you may wish to review and update your current pneumonia vaccination protocol.

Vaccines and Diabetes: Zoster (Shingles)

Type 2 diabetes has been associated with an increased risk of developing herpes zoster (shingles), especially in those individuals over age 65. The CDC currently recommends the shingles vaccine for anyone age 60 and older. The vaccine is also recommended for those who have already had shingles in an effort to prevent recurrences. The shingles vaccine has been shown to successfully reduce the risk of developing shingles by 51 percent and postherpetic neuralgia by 67 percent. [Tweet “What’s the connection between vaccines and diabetes? We’ll tell you. #longtermcarepharmacy”]

Vaccines and Diabetes: Hepatitis B

The CDC reports that people with diabetes have been shown to have higher rates of hepatitis B than the rest of the population. Additionally, outbreaks of hepatitis B have been associated with improper blood glucose monitoring and insulin pen utilization and have occurred among residents with diabetes in long-term care settings. While some individuals may have already received the hepatitis B vaccination series, it is advisable to determine a resident’s vaccination history when assessing vaccination needs while in the facility.

Vaccines and Diabetes: Tdap

Vaccination has been identified as the best way to protect against pertussis (whooping cough); however, over time, our level of protection from this vaccine begins to fade. Consequently, over the past several years, the number of pertussis cases has been on the rise.   At this time, the Tdap vaccination, which protects against tetanus, pertussis, and diphtheria, is recommended for adults every 10 years. Due to the recent changes in pertussis exposure and cases, it is a good time to review your current guidelines and processes for this vaccine. Grane Rx LTC pharmacy services encompass all aspects of a resident’s medication-related health, including vaccinations. Discover the Grane Rx difference today by calling (866) 824-MEDS (6337).]]>

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