Abstract
Diabetic patients are at higher risk of developing infectious diseases and severe complications, compared to the general population. Almost no data is available in the literature on influenza immunization in people with type 1 diabetes mellitus (T1DM). As part of a broader project on immunization in diabetic patients, we conducted a cross-sectional study to: (i) report on seasonal influenza coverage rates in T1DM patients, (ii) explore knowledge, attitudes, and practices (KAPs) towards seasonal influenza in this population, and (iii) identify factors associated with vaccine uptake, including the role of family doctors and diabetologists. A survey was administered to 251 T1DM patients attending the Diabetes Clinic at San Raffaele Research Hospital in Milan, Italy and individual-level coverage data were retrieved from immunization registries. Self-reported seasonal influenza immunization coverage was 36%, which decreased to 21.7% when considering regional immunization registries, far below coverage target of 75%. More than a third (36.2%) of T1DM patients were classified as pro-vaccine, 30.7% as hesitant, 17.9% as uninformed, and 15.1% as anti-vaccine. Diabetologists resulted to be the most trusted source of information on vaccines’ benefits and risks (85.3%) and should be more actively involved in preventive interventions. Our study highlights the importance of developing tailored vaccination campaigns for people with diabetes, including hospital-based programs involving diabetes specialists.
Highlights
Diabetes is a chronic condition heavily affecting the lives and well-being of patients and their families and economy and societies worldwide [1]
Attitudes, and practices towards influenza immunization in patients with type 1 diabetes mellitus (T1DM)
In Italy, for instance, available data on immunization coverage, in patients with diabetes, come from self-reported estimates derived from nationwide surveillance systems on lifestyle, behavioural risk factors, and access to preventive programmes coordinated by the National Institute of Health (ISS) [28]
Summary
Diabetes is a chronic condition heavily affecting the lives and well-being of patients and their families and economy and societies worldwide [1]. As reported by the International Diabetes Federation (IDF), 463 million people worldwide currently live with a diagnosis of Diabetes Mellitus (DM), causing a global health expenditure of $760 billion [2,4]. This includes both direct costs, related to the treatment of diabetes and its complications, and indirect costs due to production losses of working-age individuals and premature deaths [5]. Compared to the general population, diabetic patients are at higher risk of developing infectious diseases and their severe complications, with higher hospitalization and death rates [6,7,8,9]. A recent cohort study in Canada found that patients with diabetes had a 21%
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