My education: BSc Microbiology, MBiol Biology (with Virology), University of Leeds
Vaccines and diabetes.
Whether you have Type 1 or Type 2 diabetes, the chances are that at some point you’ve been contacted by your GP or other healthcare professional about being vaccinated against illnesses such as the flu. I know that every year in October, I get a text from my GP services asking me to book in for a jab. Whoever was with me at the time of receiving the text, whether it be a family member of a friend, would always be somewhat insulted that their GP hadn’t thought to offer them the same service. Why would I be offered this protective medicine and not them? What prioritised me over everyone else?
What are vaccines?
In simple terms, vaccines are cocktails of inactivated or attenuated forms of a virus. These ‘weakened’ versions of a virus trigger an immune response within an individual and provides them with the necessary immunological protection against the virus (without serious infection). This means that after vaccination against a virus, that person will have immunity (protection) against that virus, meaning they won’t become unwell upon future exposure.
Keeping clean and sanitised has always been important to me. I will always have a pack of these antibacterial wipes in my bag or in a coat pocket. They're small, convenient and effective at making my hands clean. With the increasing spread of the 2019-nCoV, I think it's a good idea to invest. I've put a link below.
Types of vaccines
There are four main types of vaccines:
Live attenuated vaccines
Live attenuated vaccines against measles, mumps, and chickenpox contain laboratory-weakened versions of the original pathogenic agent.
Therefore, these vaccines produce a strong cellular and antibody responses and typically produce long-term immunity with only one to two doses of the vaccine.
Whilst live attenuated vaccines are generally safe, they can revert to the virulent form, and it is important that they are not given to immunodeficient subjects (such as diabetics).
Inactivated vaccines use the ‘dead’ version of a virus in order to develop immunity. Unlike live attenuated vaccines, inactivated vaccines don’t necessarily provide immunity for as long. Because of this, booster vaccines may be needed to provide long-term protection.
What vaccines might I be recommended?
Influenza is a highly contagious, acute viral infection that affects people of all ages.
Those infected with influenza will tend to display symptoms such as aches, cough, fever and headache, although most recover within 2-7 days without significant complications.
The elderly and the immunocompromised are at greater risk of developing serious illness or dying from such infections. This includes those living with diabetes.
There are a handful of different influenza vaccines that are used.
“CDC recommends use of any licensed, age-appropriate influenza vaccine during the 2019-2020 influenza season, including inactivated influenza vaccine [IIV], recombinant influenza vaccine [RIV], or live attenuated influenza vaccine (LAIV). No preference is expressed for any influenza vaccine over another.” Read here.
Why do we need a flu vaccine every season?
The influenza viruses evolve very quickly.
It is for this reason that last years vaccine for the influenza strains may not protect you from the current years strains.
New flu vaccines are released every year in order to keep up with the rapidly adapting virus.
Why are diabetics offered this vaccine every year?
Because we live with diabetes, we are classed as ‘high risk’. Diabetes makes us more susceptible to complications from an influenza infection.
Why are diabetics more vulnerable?
Being unwell, particularly from an infection, can raise your blood glucose levels significantly. As part of your body’s defence mechanism for fighting illness, your liver will dump more glucose into the bloodstream, regardless of whether you’re eating less than usual. The body’s natural solution to this is to produce more insulin to counteract this rise in blood glucose. But for us diabetics, our body is unable to do this.
Having diabetes makes us all more vulnerable to infection, both bacterial and viral. This is because an elevated blood glucose provides an environment for these types of microorganisms to thrive and multiply. Not only that, but elevated blood glucose interrupts the ability of our white blood cells to fight infection, making it harder for us to overcome an illness and thus increasing the likelihood for complications to occur. This is why it’s so important to keep a close eye on your blood glucose when you’re unwell.
Respiratory infections accompanied by a fever, such as those caused by coronaviruses, can cause your insulin requirements to rise and lead to an increase in insulin resistance. As a result, basal insulin requirements may rise. A severe infection accompanied by a high fever can also lead to you becoming dehydrated with incredibly high blood glucose levels. It is in these situations that the risk of ketones appearing becomes more likely. The presence of ketones in the blood is an indicator that you’re not receiving enough insulin.
When insulin (the key) is not available, glucose is unable to enter the cells of the body to be used for energy. Instead it remains in the blood, where it continues to increase in concentration. As the body is unable to use glucose as an energy source, it looks to the fat reserves. When fat is used as the energy source, chemicals known as ketones are released into the blood. Diets such as the Ketogenic diet work by placing the body in a mild state of ketosis.
In the case of diabetics, an overall lack of insulin (both basal and bolus) will lead to dangerously high levels of ketones in the blood, which causes blood to become acidic. I’m sure several gruesome images pop to your mind when you imagine your blood as acid. Rather than digesting your body from the inside out, it throws off the ‘biochemical environment’ in your body required for optimum function. The end result of being in this state is ketoacidosis - a serious condition that leads to coma and death.
How long do vaccines take to develop? Why?
Vaccines can take YEARS before they become available to the public.
Here is a quote from an article which discusses the race to develop a vaccine for the recent coronavirus outbreak.
Creating a vaccine is a slow, arduous process. Vaccines go through multiple stages of development – from discovery to animal trials all the way through to multiple different human trials. And that’s not including all the regulatory hoops the vaccine needs to pass through to reach the market. These final steps often create the bottlenecks of vaccine development. Registration, regulatory approval and large-scale manufacturing take time.
Vaccines are used to prevent and control the spread of infectious diseases that would otherwise cause serious illness.
People living with Type 1 and Type 2 diabetes are at a higher risk of complications from illness caused from viruses such as influenza (the flu). Flu related complications include pneumonia and bronchitis. Infections such as the flu make managing diabetes a lot more difficult. Diabetes can compromise the immune system, and therefore weakens our body's ability to fight off infection. Not only this, but illness can make it much harder to control your blood glucose, potentially leading to serious complications such as Diabetic Ketoacidosis.
I get vaccinated, and so should you!
Are you concerned about Coronavirus and having diabetes? Read my article here for a clear, easy to understand explanation about it all. If you know anyone that might benefit from this article or any other article on Simply Diabetic, please give this post a share.