A new study from scientists in Italy indicates that a COVID-19 vaccine, when it’s available (and we’re apparently getting close), will work just as well in diabetes patients as in those without diabetes.
Vaccines, as important as they are, aren’t equally effective in all who get them. In fact, most of the vaccines used today are less effective in older people than in younger people. But what about people with diabetes? Might vaccines be less effective for them?
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Vaccine effectiveness in diabetes patients
A recent study concluded that the influenza vaccine works just as well in diabetes patients as in elderly people without diabetes and the U.S. Centers for Disease Control and Prevention (CDC) advises diabetes patients, “Vaccines are one of the safest ways for you to protect your health, even if you are taking prescription medications.” Vaccines are vital because people with diabetes are at increased risk of developing serious complications from influenza, pneumococcal disease, hepatitis B, shingles, tetanus, diphtheria and pertussis — all of which are preventable with vaccines. In fact, diabetes patients are three times more likely than others to die from complications caused by the flu or pneumonia. Eventually, a vaccine will be developed against the COVID-19 virus that’s causing the present pandemic, and researchers are already investigating its potential effectiveness in people with diabetes.
Diabetes and the COVID immune response
The new report was published in the journal Diabetologia. Led by Vito Lampasona, MD, of the San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, in Milan, the researchers wanted to find out if COVID patients are able to mount an appropriate response to the virus if they have hyperglycemia, or high blood sugar. They began with a group of 509 patients who had a confirmed diagnosis of COVID-19. About one out of three (139) had diabetes. Of these diabetes patients, 90 had been diagnosed with diabetes before entering the hospital for COVID treatment and 49 had their diabetes diagnosed when they were admitted to the hospital. The patients who had diabetes had worse lung and kidney function, worse inflammation, and more tissue damage than those who didn’t have diabetes. The diabetes patients also were at a higher risk for dying from the virus.
When a foreign substance like a virus enters the body, the immune system responds by producing antibodies, which are proteins that recognize and latch onto the invaders (known as antigens) in order to neutralize and remove them. The authors of the new report especially wanted to investigate how well their subjects’ bodies were able to produce antibodies and therefore studied how their patients’ immune systems responded to three specific antibodies: IgG, which shows evidence of past infection, IgM, which indicates a recent or current infection, and IgA, which is found in the linings of the respiratory track and digestive system and is involved in the immune response of the mucous membranes.
They discovered that high blood sugar did not impair the immune response against the COVID-19 virus and that there were only “marginal differences” between the patients with and without diabetes. The development of antibodies was also associated with a higher chance of survival. According to Lorenzo Piemonti, MD, one of the co-authors, “Hyperglycemia does not impair the antibody response” against the virus. “The evidence that the presence of IgG antibodies against the so-called ‘spike protein’ is associated with a remarkable protective effect — about a 60% reduction — in COVID-19 mortality in patients with diabetes allows for cautious optimism on the efficacy of future vaccines…in people with diabetes, who are particularly vulnerable in this deadly pandemic.”