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09-04-2014 | Diabetes | Article

Influenza burden increased among diabetes patients


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medwireNews: Working-age people with diabetes are significantly more likely to be hospitalised during influenza season than their non-diabetic peers, study findings indicate.

In an observational study of 56,513 adults with diabetes and 110,202 non-diabetic controls, Canadian researchers compared the rates of all-cause hospitalisation, influenza-like illness and hospitalisation for pneumonia and influenza during the influenza season with those during the off-season, to determine the “influenza-attributable effect”.

They found that those with diabetes experienced a significant 6% greater increase in influenza-attributable all-cause hospitalisations than those without diabetes, with rate ratios (RRs) of 1.06 and 1.00, respectively.

“Since a similar difference was not observed for [influenza-like illness], we infer that adults with diabetes experience a disproportionately greater susceptibility to more serious manifestations of influenza, requiring hospitalisation”, write Jeffrey Johnson (University of Alberta, Edmonton) and colleagues in Diabetologia.

They add that the data, collected during 745,777 person-years of follow-up between 2000 and 2008, provide “a clinical justification for targeted anti-influenza interventions”.

As well as increased all-cause hospitalisations, the researchers report significant increases during influenza season in the rates of influenza-like illness (RR=1.15) and hospitalisation for pneumonia and influenza (RR=1.35) in people with diabetes, and an increase in influenza-like illness among those without diabetes (RR=1.17). However, the differences between the groups in these outcome measures were not statistically significant.

In absolute terms, influenza season was associated with six additional all-cause hospitalisations per 1000 diabetic person-years.

“Notably, if these same adults had not had diabetes they would not have experienced any [all-cause hospitalisations] due to influenza, since influenza did not appear appreciably to increase [all-cause hospitalisations] in those without diabetes”, Johnson and co-authors remark.

They conclude that their work “represents the strongest current evidence highlighting the burden of influenza, and the potential benefits of influenza vaccination, in diabetic adults.”

However, the authors acknowledge that randomised trials are needed to demonstrate influenza vaccine efficacy in working-age people with diabetes, and formal economic studies are required, “to ascertain the extent to which identifying diabetes as a high-risk indication for vaccination may mitigate the healthcare use and costs associated with influenza.”

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2014

By Laura Cowen, medwireNews Reporter