Fort Worth, TX—Does vaccination against influenza raise blood sugar levels in diabetes patients and is that a problem?

This question becomes more important as flu vaccine season begins. The Vaccine Adverse Effect Reporting System, established by the CDC, has more than 350 reports of hyperglycemia postinfluenza vaccine, according to a new study.

A report in Annals of Pharmacotherapy advises that only one case report has previously been published detailing unusual postvaccination hyperglycemia. The researchers from the University of North Texas College of Pharmacy in Fort Worth advise that the mechanism for why hyperglycemia might occur postvaccination is not fully understood.

The study team set out to identify hyperglycemia within the first 24 hours after influenza vaccination and also to identify the transient properties of hyperglycemia within 4 days after vaccination.

The recruitment for the multicenter, prospective cohort study occurred throughout San Antonio during the 2018 to 2020 influenza seasons. Adult patients were included if they had diabetes mellitus and were currently checking their blood glucose daily. Excluded were patients who had a recent medication change that would affect their blood glucose readings.

The researchers measured participants' hemoglobin A1c and blood glucose prior to vaccination with a single dose (0.5 mL) of the IM trivalent influenza vaccine. Glucose readings were collected within 24 hours postvaccination and subsequent mornings for 4 days.

Of the 34 patients included, the average patient age was 75 years, with 60% white, 30% black, and 10% Hispanic. Median fasting glucose prevaccination was found to be significantly lower than the median value 0 to 24 hours postvaccination (140 vs. 203 mg/dL, P <.0001), according to the researchers.

"Hyperglycemia was noted 0 to 24 hours postvaccination and was transient in nature with a return to baseline by post-vaccination day," the authors point out. "This trial was conducted to close a potential gap in counseling regarding the flu vaccine and decrease any potential concern surrounding the vaccine in patients with diabetes that could lead to reduced vaccination rates."

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