Abstract
ABSTRACTInfluenza is associated with an increased risk of complications, especially in diabetic mellitus patients who are more susceptible to influenza infection. Despite recommendations of the WHO and public health authorities, vaccination uptake in this population remains suboptimal. This systematic review identified 15 studies published between January 2000-March 2017 in PubMed, Embase and Cochrane Library, which provided data on immunogenicity, safety, effectiveness, and/or cost-effectiveness of seasonal influenza vaccination in diabetic patients. Immunogenicity of seasonal influenza vaccination in diabetic patients was generally comparable to that of healthy participants. One month after vaccination of diabetic patients, seroconversion rates and seroprotection ranged from 24.0–58.0% and 29.0–99.0%, respectively. Seasonal influenza vaccination reduced the risk of hospitalization and mortality in diabetic patients, particularly those aged ≥65 years. These review results demonstrate and reinforce the need and value of annual influenza vaccination in diabetic patients, particularly in alleviating severe complications such as hospitalization or death.
Highlights
Diabetes is a major global public health concern
Focusing on more severe forms of infections and associated complications, previous systematic reviews reported that allcause hospitalization, hospitalization due to influenza or pneumonia during influenza season, and all-cause mortality were reduced in elderly diabetic patients following seasonal influenza vaccination.[13,14]
Studies were critically appraised with a set of criteria that might have a significant effect on the risk of bias in the results reported and conclusions drawn
Summary
Diabetes is a major global public health concern. Its prevalence is increasing worldwide, having more than doubled in the past 20 years.[1]. Focusing on more severe forms of infections and associated complications, previous systematic reviews reported that allcause hospitalization, hospitalization due to influenza or pneumonia during influenza season, and all-cause mortality were reduced in elderly diabetic patients following seasonal influenza vaccination.[13,14]. In working-age diabetic patients, vaccination was associated with reductions in all-cause hospitalization and hospitalization for influenza and pneumonia; no direct effects on mortality were observed. Both reviews reported that the strength of available evidence was low to very low for all outcomes and residual confounding was present in most of the included studies published until January 2015. The current systematic review was undertaken to update and expand on these previous findings with the aim to provide a critical appraisal and summary of currently available data concerning the immunogenicity, safety, efficacy, effectiveness, quality of life and cost effectiveness of seasonal influenza vaccination in patients with diabetes
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