Why the Flu Vaccine Is Vital for People With Diabetes

From healthline.com

Experts say people with diabetes should keep their vaccinations up to date because ailments such as the flu can cause serious complications.

It’s back. The start of the flu season, and that leaves people with a decision about whether to get this year’s vaccine.
For people with diabetes, that question is even more crucial.
People with type 1 or type 2 diabetes have an increased risk of contracting seasonal viruses, such as the flu, and being hospitalized while fighting the disease.
For those struggling with obesity, as many people with diabetes do, infections such as whooping cough or the flu are especially dangerous.
For example, a virus that might produce a mild illness in a lean person could tip an obese person with restrictive lung physiology into overt respiratory failure.
“Pertussis — or any respiratory illness — could be worse for severely obese people who may have comorbidities such as sleep apnea and obesity hypoventilation syndrome,” Dr. Eric Sodicoff, author of the Phoenixville Nutrition Guide, told Healthline.
The American Association of Diabetes Educators (AADE) emphasizes that no matter how well-managed your diabetes may be, every eligible person with diabetes should get vaccinated.
“People with diabetes may be at higher risk of getting certain diseases and also serious problems from diseases that could’ve been prevented with vaccines,” Evan Sisson, PharmD, MHA, CDE, FAADE, and associate professor in the Department of Pharmacotherapy & Outcomes Science at Virginia Commonwealth’ University’s School of Pharmacy, told Healthline. “Everyone should know what vaccines they need to protect themselves and discuss with their doctor whether they are up to date with the vaccines.”

Experts say vaccines, such as the flu shot, will most likely not give you the illness they are designed to prevent because they contain a dead version of the virus.
Instead, the vaccines help your immune system prepare the antibodies that will fight off the virus if you come into contact with it.

A flu shot is one of a number of immunizations recommended for people with diabetes. Getty Images

 

Rewind 10 Seconds

Next Up

Loading ad

Live

00:00

00:00

00:00

Closed Captions

Settings

Fullscreen

powered by Rubicon Project

Why diabetes puts you at higher risk

Since type 1 diabetes is an autoimmune disease, the immune system of someone with the ailment has already been compromised, which means its ability to successfully fight off a virus is less likely.
“People with type I diabetes have immune systems that are less vigilant than in normal people,” Dr. Len Horovitz, a pulmonary specialist from Lenox Hill Hospital in New York City, told Healthline.
“The infection risk in diabetes, whether viral or bacterial, is well known,” Horovitz explained. “In addition, high blood sugar levels [in type 1 or type 2 diabetes] promote infection on their own.”
Horovitz adds that people with diabetes are also more susceptible to pneumococcal pneumonia, increasing the value of vaccines such as Prevnar and Pneumovax.
For patients specifically with type 1 diabetes, a simple bout of vomiting, fever and/or virus-induced dehydration can easily lead to diabetic ketoacidosis (DKA).
DKA, according to the CDC, is “an emergency condition in which extremely high blood glucose levels, along with a severe lack of insulin, result in the breakdown of body fat for energy, and an accumulation of ketones in the blood and urine. Signs of DKA are nausea and vomiting, stomach pain, fruity breath odour, and rapid breathing. Untreated DKA can lead to coma and death.”
Even with previously well-managed blood sugar levels, the addition of the flu virus within a body of a person with type 1 diabetes exacerbates its ability to manage even basic aspects of homeostasis.
A person with type 1 diabetes who is concerned they may have the flu should monitor blood sugar levels with extra diligence. They should get to an emergency room quickly to receive intravenous fluids (saline, electrolytes, and sometimes insulin and glucose) if blood sugars seem resistant to insulin doses, at the first sign of vomiting, and if ketone levels on urine or blood test-strips become moderate to large.
People with type 1 and type 2 diabetes are also twice as likely to die of a complication related to the flu, according to a 2018 study from the Indian Journal of Endocrinology and Metabolism.

Why vaccines are important

Approximately 80,000 people die each year from the flu, including otherwise healthy children.
Getting the flu shot and other vaccines like Tdap (for tetanus, diphtheria, and whooping cough) not only protects you, it protects those unable to get vaccinated, like babies under 6 months, and people with severe allergies to vaccine ingredients.
Experts say the flu shot can’t give you the flu because it contains a dead virus. Instead, it simply helps your body prepare your immune system with the antibodies that will help fight off the flu if you come in contact with the virus.
“AADE has partnered with the Centres for Disease Control and Prevention (CDC) to spread the word on vaccines that are important for people living with diabetes,” explains a recent press release from the AADE.

These vaccines include:

Influenza vaccine: “A flu shot is the single best way to protect against seasonal flu. Flu puts people with diabetes at high risk for health complications such as increased blood glucose levels. The illness can also lead to more serious sicknesses such as pneumonia, bronchitis, sinus infections, and ear infections, often resulting in hospitalization, and sometimes even death.”

“People should get a flu vaccine annually, and the vaccines are already available this year.”

Tdap vaccine: “The Tdap vaccine protects against three serious diseases caused by bacteria: tetanus, diphtheria and pertussis, or whooping cough.”

“People should get the Tdap vaccine every 10 years.”

Zoster vaccine: “The zoster vaccine reduces the risk of developing shingles and PHN, serious illnesses for unvaccinated people as they age.”

“People age 50 and older should get the Zoster vaccine.”

Pneumococcal vaccine: “People with diabetes are at an increased risk for death from pneumococcal infections, which can include infections of the lungs, blood, ear, and lining of the brain and spinal cord.”

“People with diabetes should get the pneumococcal vaccine once before the age of 65 and twice more after.”

Hepatitis B vaccine: “Since hepatitis B can be spread via shared blood glucose meters, finger-stick devices, and other diabetes care equipment, it’s critical that people with diabetes receive the vaccine.”

“The hepatitis B vaccine should be given to people who are younger than 60. People age 60 or older should ask their doctors about the vaccine.”

The bottom line

Diseases such as the flu can cause serious complications for people with diabetes or for those who are obese.
People with type 1 and type 2 diabetes are also twice as likely to die of a complication related to the flu, explains a 2018 study from the Indian Journal of Endocrinology and Metabolism.
For these reasons, it’s important for people with diabetes to get vaccinated against the flu as well as other diseases.

https://www.healthline.com/health-news/why-its-important-for-people-with-diabetes-to-get-vaccinated#The-bottom-line

The many ways diabetes affects your eyes

From star2.com

Diabetes can affect the eyes in many ways. Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye.
It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness in adults.
This condition usually develops in anyone who has poorly controlled type 1 or type 2 diabetes.

Diabetic eye diseases also include cataract and glaucoma:
• Cataract: Adults with diabetes are two to five times more likely than those without diabetes to develop cataract. It also tends to develop at an earlier age.
• Glaucoma: Certain types of glaucoma are associated with elevated pressure inside the eye. In adults, diabetes nearly doubles the risk of glaucoma.

All forms of diabetic eye disease have the potential to cause severe vision loss and blindness.

Types of diabetic retinopathy
There are three types of diabetic retinopathy:
• Non-proliferative retinopathy is an early form of the disease, where the retinal blood vessels leak fluid or bleed.
• Macular oedema is a swelling of the macula, caused by the leakage of fluid from retinal blood vessels. It can damage central vision.
• Proliferative retinopathy is an advanced form of the disease and occurs when blood vessels in the retina disappear and are replaced by new fragile vessels that bleed easily. This can result in a sudden loss of vision.
One might not have symptoms in the early stages of diabetic retinopathy. It usually affects both eyes.
As the condition progresses, symptoms may include:
• Spots or dark strings floating in your vision (floaters).
• Blurred vision.
• Fluctuating vision.
• Impaired colour vision.
• Dark or empty areas in your vision.
• Vision loss.

What causes diabetic retinopathy?
Chronically high blood sugar from diabetes is associated with damage to the tiny blood vessels in the retina, leading to diabetic retinopathy.
It can cause blood vessels in the retina to leak fluid or haemorrhage (bleed), distorting vision.
In its most advanced stage, new abnormal blood vessels proliferate (increase in number) on the surface of the retina, which can lead to scarring and cell loss in the retina.
Diabetic retinopathy may progress through four stages:
1. Mild non-proliferative retinopathy
2. Moderate non-proliferative retinopathy
3. Severe non-proliferative retinopathy
4. Proliferative diabetic retinopathy (PDR).
At this advanced stage, growth factors secreted by the retina trigger the proliferation of new blood vessels, which grow along the inside surface of the retina and into the vitreous gel, the fluid that fills the eye.
The new blood vessels are fragile, which makes them more likely to leak and bleed.
Accompanying scar tissue can contract and cause retinal detachment – the pulling away of the retina from underlying tissue, like wallpaper peeling away from a wall. This can lead to permanent vision loss.
The risk of developing diabetic retinopathy can increase as a result of:
• Duration of diabetes – The longer one has diabetes, the greater risk of developing diabetic retinopathy.
• Poor control of blood sugar level.
• High blood pressure.

• High cholesterol levels.
• Pregnancy.
• Smoking.
Diabetic retinopathy and diabetic macular oedema are detected during a comprehensive dilated eye exam that includes:
• Visual acuity testing.
• Pupil dilation – allowing a physician to examine the retina and optic nerve.
• Optical coherence tomography (OCT) – Scanning of the nerve fibre layers.
A comprehensive dilated eye exam allows the doctor to check the retina for:
• Changes to blood vessels.
• Leaking blood vessels or warning signs of leaky blood vessels, such as fatty deposits.
• Swelling of the macula (DME).
• Changes in the lens.
• Damage to nerve tissue.

Complications of diabetic retinopathy
Complications can lead to serious vision problems such as:
• Vitreous haemorrhage – The new blood vessels may bleed into the clear, jelly-like substance that fills the centre of eye.

If the amount of bleeding is small, one might see only a few dark spots (floaters).

In more severe cases, blood can fill the vitreous cavity and completely block vision.

• Retinal detachment – The abnormal blood vessels associated with diabetic retinopathy stimulate the growth of scar tissue, which can pull the retina away from the back of the eye, which will cause severe vision loss.

• Glaucoma – New blood vessels may grow in the front part of your eye and interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build up.

• Blindness – Eventually, diabetic retinopathy, glaucoma or both can lead to complete vision loss.

Preventing diabetic retinopathy

Regular eye exams, good control of your blood sugar and blood pressure, and early intervention for vision problems can help prevent severe vision loss.

• Manage your diabetes. Make healthy eating and physical activity a part of your daily routine.

Take oral diabetes medications or insulin as directed.

• Monitor blood sugar level. You may need to check and record your blood sugar level several times a day.

• Keep blood pressure and cholesterol under control.

• Stop smoking. Smoking increases the risk of various diabetes complications, including diabetic retinopathy.

• Pay attention to vision changes.

Treating diabetic retinopathy

Vision lost to diabetic retinopathy is sometimes irreversible. However, early detection and treatment can reduce the risk of blindness by 95%.

Because diabetic retinopathy often lacks early symptoms, people with diabetes should get a comprehensive dilated eye exam at least once a year.

People with diabetic retinopathy may need eye exams more frequently, and women with diabetes who become pregnant should have a comprehensive dilated eye exam as soon as possible.

Additional exams during pregnancy may be needed.

Early diabetic retinopathy – If one has mild or moderate non-proliferative diabetic retinopathy, one may not need treatment right away.

However, the eye doctor will closely monitor the eyes to determine when you might need treatment.

Work with a diabetes doctor (endocrinologist) to determine if there are ways to improve diabetes management. When diabetic retinopathy is mild or moderate, good blood sugar control can usually slow the progression.

Advanced diabetic retinopathy – If one has proliferative diabetic retinopathy or macular oedema, one will need prompt surgical treatment.

Photocoagulation, also known as focal or grid laser treatment, can stop or slow the leakage of blood and fluid in the eye.

During the procedure, leaks from abnormal blood vessels are treated with laser burns. It is usually done in an eye clinic.

Panretinal photocoagulation, also known as scatter laser treatment, can shrink abnormal blood vessels.

During the procedure, the areas of the retina away from the macula are treated with scattered laser burns. The burns cause the abnormal new blood vessels to shrink and scar.

Some loss of peripheral vision or night vision after the procedure is possible.

In vitrectomy, a tiny incision is made in the eye to remove blood from the middle of the eye (vitreous), as well as scar tissue that’s tugging on the retina.

It’s done in a surgery centre or hospital using local or general anaesthesia.

The eye doctor may also suggest injecting medication into the vitreous of the eye.

These medications, called vascular endothelial growth factor (VEGF) inhibitors, may help stop growth of new blood vessels by blocking the effects of growth signals the body sends to generate new blood vessels.

The doctor may recommend these medications, also called anti-VEGF therapy, as a stand-alone treatment or in combination with panretinal photocoagulation.

All the above treatments slow or stop the progression of diabetic retinopathy, but it’s not a cure. Because diabetes is a lifelong condition, future retinal damage and vision loss are still possible.

https://www.star2.com/health/2018/10/08/how-diabetes-affects-your-eyes/

Type 2 diabetes: Flu can be serious if blood sugar is high - what to do if you get ill

From express.co.uk

TYPE 2 diabetes can increase the risk of getting the flu, and if sufferers of the blood sugar condition catch the winter bug, it could cause serious health complications. This is what to do if you have diabetes and fall ill with the flu.

Type 2 diabetes is a lifelong condition where the level of sugar in the blood is too high.
It’s dangerous because if not treated properly it can cause serious complications involving the heart, eyes, kidneys and nerves.
People with diabetes are also more at risk of getting the flu.
Although most healthy people recover from the flu within a couple of weeks, the effects are worse in people with diabetes.

Catching the flu can also increase the risk of developing other diabetes related complications.
“Winter conditions can be very bad for your health, especially if you’re living with diabetes,” said Diabetes UK.
“Flu is serious, and can make your blood sugar go all over the place.”
“If your blood sugar isn’t within target, the effects of flu can be dragged out and increase your risk of developing serious complications.”
If you have diabetes and catch the flu, Diabetes UK advises going to see your doctor or nurse as soon as possible, as they will be able to tell you what to do.

Having diabetes can increase the risk of getting the flu, and symptoms can be worse (Image: Getty Images)

If unwell, stop taking SGLT2 inhibitor tablets, but continue taking any other diabetes treatments.
SGLT2 inhibitors reduce the amount of glucose being absorbed in the kidneys so it is passed out in the urine, while also reducing the amount of glucose in the blood.
It’s important to keep warm, both indoors and outdoors, ensuring heating in the house is at least 18 degrees.
As the flu can cause blood sugar to fluctuate, it may be necessary to test it more often than normal.
It’s also vital to keep fluid intake up and eat, even if you don’t feel like it.

This is because some medications require eating regular meals, so try to eat a little and often.
Carbohydrate-based drinks, like milk or juices, may help manage blood sugar alongside any medication.
“If your symptoms don’t improve, you need to see your GP. Don’t waste time. Leaving things until they get worse might lead to more serious infections,” said the NHS.
In order to prevent the flu in the first place, people with diabetes are advised to get the flu jab.
It’s recommended to get the flu jab before winter starts, every year.
The flu jab is available on the NHS for free, for people with diabetes.

https://www.express.co.uk/life-style/health/1028026/type-2-diabetes-flu-can-cause-complications-how-to-treat-it

Can a Vegan Diet Prevent Type 2 Diabetes?

From diabetesselfmanagement.com

A new study in the journal Nutrients of heavy-to-overweight adults suggests a low-fat, plant-based vegan diet can potentially lower the risk of a person developing Type 2 diabetes. According to lead author Hana Kahleova, MD, PhD, of the Physicians Committee for Responsible Medicine, “…this study adds to the growing evidence that food really is medicine and that eating a healthful plant-based diet can ago a long way in preventing diabetes.”
For their study, the researchers recruited 73 adults age 25–75 (8 men and 67 women). They didn’t have diabetes but were heavy-to-overweight (their body-mass indexes [BMI] ranged from 28–40). The participants who went on a vegan diet were instructed to avoid animal products and added fats while taking a vitamin B-12 supplement. The dieters got 75 percent of their calories from carbohydrates, 15 percent from protein, and 10 percent from fats. A control group was told not to change their normal diet, although both groups were asked to limit alcohol intake. The study lasted for 16 weeks.

The researchers found that the vegan diet brought distinct increases in the secretion of insulin after meals. They also reported increased beta-cell glucose sensitivity (the beta cells store and release insulin). In addition, the dieters showed positive changes in BMI and visceral fat (the fat that surrounds the internal organs). These changes were not reported in the control group. The researchers summed up the findings by writing, “Our study suggests the potential of a low-fat plant-based diet in diabetes prevention, addressing both core pathophysiologic mechanisms — insulin resistance and diminished beta-cell function — at the same time.”

https://www.diabetesselfmanagement.com/blog/can-a-vegan-diet-prevent-type-2-diabetes/

Type 2 diabetes: Should sufferers of the condition get the flu jab this autumn?

From express.co.uk

TYPE 2 diabetes can increase the risk of getting the flu, which can disturb blood glucose levels. So is it worth getting the flu jab if you suffer from the blood sugar condition?

Type 2 diabetes occurs when the level of sugar in the blood is too high.
Having a too high level of sugar in the blood is dangerous, because it can lead to serious health problems involving the heart, nerves, kidneys and eyes.
Everybody is at risk of getting the flu during the autumn and winter months, however certain people are more likely to catch the virus than others.
People more at risk include those who are aged 65 or over, young children, pregnant women, and those with an underlying health condition, such as diabetes.

People who fall into any of these categories are advised to get the flu jab. It is free for those people on the NHS.
“Anyone with diabetes, including those who are pregnant, should get a jab against flu,” said Diabetes UK.
“This is because people with diabetes are more at risk of getting the flu and having diabetes will make it worse.”
The flu in people who are otherwise healthy will usually clear up on its own within a week.
However, in those with diabetes, the flu can disturb blood sugar levels.

People with underlying medical conditions such as diabetes are advised to get the flu jab (Image: Getty Images)

If blood sugar isn’t within target, the effects of flu can be dragged out and increase the risk of developing serious complications.
Getting the flu vaccine can protect you from the most common types of flu currently around.
As this changes each year, it means having to get a new flu jab each year.
The NHS advises getting the flu jab between the beginning of October to the end of November, as it can take about two weeks to work.
It is still possible to get the flu in those two weeks, so it’s best to get the jab ahead of the colder winter months.

It’s advisable not to get the flu jab, however, during periods of illness or infection, especially if you have a fever.
If you are unwell, wait until you are better before getting the vaccine.
Diabetes UK warns on the possibility of higher-than-normal blood sugar levels after the flu jab, but this should settle as the body returns to normal.
If, however, blood sugar levels remain consistently high, talk to a doctor or healthcare professional.
“Winter conditions can be very bad for your health, especially if you’re living with diabetes,” said Diabetes UK.
“That’s why you really need to get your free flu jab before winter starts.”

https://www.express.co.uk/life-style/health/1026091/type-2-diabetes-should-sufferers-get-flu-jab-this-autumn

Type-2 diabetes signs 'detectable years before diagnosis'

From bbc.co.uk

The warning signs of type-2 diabetes may be detectable 20 years before the disease is diagnosed, researchers say.

Elevated fasting blood sugar levels and insulin resistance were seen in people years before they developed pre-diabetes, often a pre-cursor to type-2, a study found.
The findings suggest interventions to stop the disease in its tracks should begin far earlier in life, authors say.
Another study found type-1 diabetes may be misdiagnosed after the age of 30.

'Intervene much earlier'

The Japanese study, carried out between 2005 and 2016, looked at the body mass indexes (BMIs), fasting blood sugar levels and insulin sensitivity of 27,000 non-diabetics, who were aged between 30 and 50 and were mostly men.

Insulin resistance occurs when cells of the body do not respond properly to the hormone insulin and can lead to a variety of health problems.
A higher BMI is a well known risk factor for type-2 diabetes.
The study followed participants until they were diagnosed with type-2 diabetes, pre-diabetes - where blood sugar levels are abnormally high - or the end of 2016, whichever came first.
Over the study period, 1,067 new type-2 diabetes cases were diagnosed.
Researchers found these people had had increased fasting blood sugar levels and insulin resistance, along with higher BMIs, up to 10 years before diagnosis.
A similar pattern was observed in those who went on to develop pre-diabetes - the same kind of warning signs, albeit to a lesser degree, had been detectable more than a decade before they were diagnosed.

Because most people who develop type-2 diabetes first go through a pre-diabetes stage, researchers say it means the warning signs of the condition may be detectable more than 20 years before an actual diagnosis.
Dr Hiroyuki Sagesaka, from Aizawa Hospital in Matsumoto, Japan, who led the research, said: "Because trials of prevention in people with pre-diabetes seem to be less successful over long-term follow-up, we may need to intervene much earlier than the pre-diabetes stage to prevent progression to full blown diabetes.
"A much earlier intervention trail, either drug or lifestyle-related, is warranted."
Diabetes UK said about a million people in the UK were thought to have type-2 diabetes and not yet know it.
But the charity points out that pre-diabetes does not have to develop into type-2 - people can usually make lifestyle changes to prevent this.
Diabetes UK added: "Knowing your risk at any point in time is of course helpful in avoiding or preventing a diagnosis of type-2 diabetes.
"Whether you're at increased risk of type-2 diabetes or not, everyone should be encouraged to live a healthier lifestyle by eating better and moving more."
The research is being presented at the European Association for the Study of Diabetes conference and published in The Journal of Endocrine Society.

Separately, people who develop type-1 diabetes later in life are at risk of being misdiagnosed with the type-2 version of the disease, research suggests.
This small study indicated 39% of people diagnosed with type-1 diabetes after the age of 30 were not immediately given insulin.
Type-1 diabetics need to be given insulin immediately, while those with type-2 can often treat the condition by improving their diet and exercising more.
Dr Nick Thomas, from the University of Exeter, who led the research, said: "Getting the right diagnosis is important for these patients to receive the right education and treatment."

https://www.bbc.co.uk/news/health-45747042

Diabetes type 2: Try these easy exercise tips to help keep your blood sugar levels low

From express.co.uk

DIABETES type 2 is a lifelong condition which has no cure, but there are ways to control it and prevent complications from occurring, as well as steps you can take to reduce the risk of it developing at all. Keeping active is one way to achieve this.

Diabetes type 2 is when the level of sugar in the blood is too high.
It occurs in people whose bodies don’t produce enough insulin, or whose cells don’t react to insulin.
Insulin is needed to control glucose in the blood and ensure it enters the cells to be burned into energy.
Without insulin, too much sugar stays in the bloodstream, which can lead to heart disease and strokes, nerve damage, foot problems, vision loss and blindness and kidney problems.

However, complications can be prevented by taking medication and making lifestyle changes, such as eating a healthy diet and keeping active.
Maintaining a healthy body weight can also prevent people from developing diabetes type 2 in the first place, as overweight people are more at risk.
“Spending less time sitting down and more time being active is key to preventing type 2 diabetes,” said Diabetes UK.
So what’s the best way to keep active and how much exercise should you get?

Types of exercise
Anything from an activity class, to sports, to just doing more around the house can help you to become more active.

              Keeping active can help keep blood sugar levels under control (Image: Getty Images)

Diabetes UK recommends walking, cycling, swimming as forms of moderate exercise, and running, sports and fitness classes as forms of vigorous exercise.
Heavy gardening, carrying groceries and yoga can also help improve muscle strength.
Little things like taking the stairs instead of the lift or getting off the bus one stop earlier can also make a difference.

How much exercise?
Diabetes UK advises doing 30 minutes of moderate activity, five days a week, or 15 minutes of vigorous activity, five days a week.

Activities which improve muscle strength are also recommended for at least two days a week.
Breaking the time into smaller chunks and building up to these amounts gradually can help you ease into it.
“Walking can be a great way to start and it's something you can build into your everyday routine – it's also free,” said Diabetes UK.
“Moving more each day will help you lose weight and help to maintain a healthy weight.”
“Even moving a little more makes a big difference.”

https://www.express.co.uk/life-style/health/1025109/diabetes-type-2-easy-exercise-tips-control-blood-sugar-levels