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COVID-19 Vaccines and Patients With Diabetes

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COVID-19 Vaccines and Patients With Diabetes

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Diabetic patients are at a higher risk of developing COVID-19 infection, and they should get vaccinated as early as possible. Read the article to learn more.

Medically reviewed by

Dr. Radha Peruvemba Hariharan

Published At July 2, 2021
Reviewed AtAugust 14, 2023

Introduction:

The novel Coronavirus disease has affected millions of people globally, especially with a poor prognosis in patients with diabetes mellitus. Diabetes patients with COVID-19 are associated with, severe disease, intensive care unit admissions and increased mortality.

Patients with both type 1 and type 2 diabetes mellitus have an increased vulnerability to COVID-19 disease than people without diabetes mellitus. In addition, even if there was good glycemic control before hospital admission, there was not a consistent improvement in patients with diabetes mellitus admitted with COVID-19. Thus, primary prevention for COVID-19 patients with diabetes mellitus is the mainstay to make it less severe and, getting vaccinated within the appropriate time interval is considered an important step of primary prevention.

Routine vaccination is recommended in patients with diabetes mellitus against,

Previously, it was said that patients with diabetes mellitus had a weakened antibody response to influenza and hepatitis B vaccines. But with recent advances in the development of vaccines, people with diabetes mellitus are able to get an appropriate immune response post-vaccination. As people with diabetes mellitus carry the burden of the disease, they are prioritized with COVID-19 vaccinations.

Why Diabetic Patients Are at a Higher Risk of Having COVID-19 Infection?

Diabetic patients are known to have a greater risk of developing infections, such as skin infections, genito-urinary tract infections, and respiratory tract infections. Hyperglycemia in diabetic patients through several pathways favors immune dysfunction. Decreased production of interleukins in response to an infection and reduced phagocytic and chemotaxis activity are the most important underlying mechanisms. Hyperglycemia increases the virulence of certain viruses and bacteria. Clinical reports suggest that diabetes mellitus is one of the most common comorbidities in patients with COVID-19 infection. Diabetic patients have a high risk of infection as well as an increased incidence of hospitalization. Clinical reports suggest that diabetes mellitus is one of the most common comorbidities in patients with COVID-19 infection.

Getting vaccinated with COVID-19 in patients with diabetes mellitus depends on the place we live. The Centers for Disease Control and Prevention (CDC) has made recommendations on who are of utmost priority for vaccinations. Each state plans according to these recommendations and distributes the vaccines to each resident.

Some states offer vaccines to people above 16 years of age, including those with diabetes. Due to the availability of vaccines, CDC has recommended vaccines for all people including those with type 2 diabetes and other underlying medical conditions

Initially the American Diabetes Association (ADA) prioritized vaccines for type 1 and type 2 diabetes mellitus equally as both groups had a similar increased risk for dangerous COVID-19 disease. Earlier decisions on vaccination priority were made by each state but as of now with increased production of vaccines, they are made available for everyone. Few nations have started administering COVID-19 vaccines even to children.

Why Is It Important to Get Vaccinated if Suffering From Diabetes Mellitus?

The immune response to vaccines is important for people with diabetes mellitus as they are at increased risk for developing serious COVID-19 disease. It is said that people with diabetes do much worse than people without diabetes from the following outcomes of COVID-19,

  • Roughly half of the people who died from COVID-19 under 65 years of age had diabetes.

  • People with type 1 or type 2 diabetes are,

  1. More likely to be hospitalized or experience the severe illness of COVID-19 when compared with people without diabetes.

  2. More likely to die from COVID-19 in the hospital than people without diabetes.

  3. More likely to die or to be treated in the intensive care unit for COVID-19.

So, depending on the area a person lives in, know the availability of the vaccine from a healthcare provider. Also, health departments, pharmacies, doctor offices, and hospitals play a major role in administering vaccines.

Is the COVID Vaccine Safe for People With Diabetes?

Currently, there are 38 approved vaccines (that are approved by different national Government bodies) and ten vaccines that are listed by WHO (World Health Organization) for Emergency Use Listing (EUL). The vaccines granted Emergency Use Listing (EUL) by WHO are:

  • Sputnik V (Gamaleya).
  • Covilo (Sinopharm).
  • CoronaVac (Sinovac).
  • Ad26.COV2.S (Johnson & Johnson).
  • Spikevax (Moderna).
  • Comirnaty (Pfizer and BioNTechv).
  • Covaxin (Bharat Biotech).
  • Covovax and Covishield (Serum Institute of India).
  • Nuvaxovid (Novovax).
  • Vaxzevria (Oxford/AstraZeneca).

The COVID-19 vaccines are safe for people with type 1 or type 2 diabetes, prediabetes, or gestational diabetes. The vaccines were approved by the United States Food and Drug Administration under an emergency use authorization. To be approved, vaccines must go through a rigorous trial process that includes several phases addressing safety and efficacy. However, the data on immune response in diabetic patients with COVID-19 are scarce. A few prominent clinical trials have been done to test the safety of these vaccines in adults of all ages, as well as chronic health conditions. These include:

  • The Pfizer-BioNtech trial included 3,100 people with diabetes. It is an mRNA vaccine with 95 % effectiveness at preventing COVID with symptoms.

  • The Moderna trial included 2,800 people with type 1, type 2, and gestational diabetes. It is an mRNA vaccine with 94 % effectiveness at preventing COVID with symptoms.

  • The Johnson and Johnson trial included 3,300 people with type 1 and 2 diabetes. It is a viral vector with 66 % effectiveness at preventing COVID with symptoms and 85 % effectiveness against severe COVID-19 illness.

What Are the Side Effects of the COVID Vaccine That Diabetes Patients Should Pay Attention To?

In general, side effects in patients with diabetes mellitus following vaccination are usually mild. But some people have more severe adverse effects that can interfere with their daily activities.

The Most Common Side Effects are,

  • Pain.

  • Swelling.

  • Redness at the injection site.

Other Common Side Effects are,

  • Chills.

  • Tiredness.

  • Headaches.

It is said that the side effects of the COVID-19 vaccines are similar to flu vaccines, and no severe allergic reactions were reported. So, patients with diabetes should monitor their blood glucose levels and have extra medications with a sick day kit as it would be beneficial when feeling unwell.

Vaccines Affecting Blood Glucose Levels:

As vaccines cause symptoms of illness and can lead to high glucose levels, it is important to monitor the blood glucose levels carefully for 48 hours after vaccination. Also, stay hydrated and have a sick day plan ready as people with diabetes show few side effects and minor effects on blood sugar levels.

Diabetic Medications Affecting the Vaccine:

Till now, there is no information on drug interactions between COVID vaccines and other medications. However, the vaccine is not expected to interact with Insulin or other standard diabetes medications. Also, avoid the following for several days after vaccination on the vaccine injection site,

  • Injecting Insulin.

  • Placing a glucose sensor.

  • Pump infusion.

Conclusion:

When receiving the COVID vaccine, the healthcare professional will provide a paper card, which helps to know about the name of the vaccine received, the date, and the place of vaccination. Also, it provides information about the vaccine, its benefits, and its side effects. After the injection, the healthcare professional will make the person stay for some time to monitor the bodily reactions.

After receiving both doses of the vaccine, still, it is important to follow COVID safety protocols like wearing a face mask that fits you, avoiding close contact with people, social distancing for at least two meters, wash your hands, monitoring the health, and avoiding touching the face, especially eyes, nose, and mouth. Continue to follow these measures to protect others and yourself from beating the pandemic.

Frequently Asked Questions

1.

Should Someone With Diabetes Receive the COVID Vaccine?

People with diabetes need to obtain immunization. Everyone who is at least six months old is eligible for vaccination. A booster is available to those who are at least five years old.

2.

Which Vaccinations Are Advised for Diabetics?

The COVID-19 vaccine can lower the risk of serious disease and death if one has diabetes. However, the blood sugar might increase for a couple of days.

3.

How Do Diabetics Respond to COVID?

A COVID-19 infection will momentarily increase the blood sugar levels of many persons at risk for diabetes. However, the blood sugar levels will return to normal after the infection has subsided.

4.

Does COVID Influence the Levels of Blood Sugar?

Yes, COVID-19 can influence blood sugar levels.The infection can cause stress, inflammation, and hormonal changes, leading to elevated blood glucose levels, particularly in individuals with diabetes. 

5.

If Has Diabetes or Heart Disease, Is the COVID Vaccine Safe?

There is no need for concern. But, the body responds to the vaccine because one has never had it before. The COVID-19 vaccination carries the same risk as any other vaccine because it could temporarily raise blood sugar levels.

6.

Is Pfizer Vaccination Available for Diabetics Patients?

Yes, the Pfizer-BioNTech COVID-19 vaccine is available and recommended for diabetic patients. The vaccine has been approved and authorized for use in individuals aged 12 and older, including those with underlying health conditions such as diabetes.

7.

Do Diabetics Need to Have the Booster Shot?

People living with diabetes need to obtain immunization. The best approach to protect people from COVID-19 is with the whole vaccine and booster. Everyone who is at least six months old is eligible for vaccination. A booster is available to those who are at least five years old.

8.

Why Are Diabetics More at Risk From COVID?

Serious COVID-19 problems are more likely to occur in people with diabetes. Generally speaking, when exposed to any virus, people with diabetes are more prone to experience more severe symptoms and problems. Like other viral infections, COVID-19 could make it more likely for people to become critically unwell if they also have heart disease or other issues in addition to diabetes since having many illnesses makes it more difficult for the body to fight the infection.

9.

Are Diabetics' Immune Systems Compromised?

Unfortunately, diabetes disrupts the host's immunological response. T2D can impact cellular immunity in addition to the possibility of natural barrier deterioration brought on by neuropathy. A lack of insulin and high blood sugar is to blame for this.

10.

Does the Pfizer Vaccine Have an Impact on Blood Sugar Levels?

The body will begin to create an immunological reaction after receiving the vaccine. The body may release some extra glucose from its reserves to accomplish this. There is no cause for concern here. Because the vaccine is novel to the patient, the body reacts to it.

11.

Is Diabetes a Kind of Autoimmunity?

Type 1 diabetes (T1D) is an autoimmune condition that affects only one organ and is brought on by an immunological reaction against pancreatic cells.

12.

What Vitamins Are Recommended for Diabetics?

If a person has type 2 diabetes and a B12 deficiency, a supplement may be beneficial. For example, vitamin B12 levels are decreased in people with type 2 diabetes who use Metformin. If the patient takes Metformin, ask the doctor to get tested for a B12 deficiency regularly.

13.

After COVID, Can Diabetes Go Away?

A COVID-19 infection will momentarily increase the blood sugar levels of many persons at risk for diabetes; however, after the infection has subsided, the blood sugar levels will return to normal.
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Dr. Radha Peruvemba Hariharan

Diabetology

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