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There has always been little evidence supported influenza vaccinations in working-age adults with diabetes, despite guidelines advocating the flu jab. However now Canadian researchers have confirmed that this group of adults are especially susceptible to serious influenza-related diseases.

The researchers analysed data for 56,513 adults aged less than 65 years with diabetes, each of whom was matched with up to two non-diabetic controls (n=110,202). The median age was 51 and 50 years in those with diabetes and controls respectively, while 47 and 48 per cent respectively were women.

People with diabetes had more concurrent diseases than controls (e.g. 27 and 12 per cent had at least two major co-morbidities in the last two years respectively).

Sixteen per cent of people with diabetes were vaccinated for influenza in the previous year compared with seven per cent of controls.

Nevertheless, compared to controls, people with diabetes were:

• 26 per cent more likely to be hospitalised for pneumonia and influenza
• 13 per cent more likely to develop an influenza-like illness
• 6 per cent more likely to need all-cause hospitalisation.

Neither the rates of influenza-like illness nor hospitalisation for pneumonia and influenza reached statistical significance. However, the increase in all-cause hospitalisations was statistically significant. Flu accounted for 98 per cent of all-cause hospitalisations among people with diabetes. The influenza season was associated with six extra all- cause hospitalisations per 1,000 person-years in people with diabetes. The authors commented that their findings “represent the strongest available evidence for targeting diabetes as an indication for influenza vaccination, irrespective of age”. (Diabetologia)