Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 15, 2021; 12(12): 2107-2118
Published online Dec 15, 2021. doi: 10.4239/wjd.v12.i12.2107
Rates and associates of influenza and pneumococcus vaccination in diabetes mellitus: A nationwide cross-sectional study (TEMD vaccination study)
Ibrahim Demirci, Cem Haymana, Serpil Salman, Ilker Tasci, Demet Corapcioglu, Ali Kirik, İlhan Yetkin, Mustafa Altay, Tevfik Sabuncu, Fahri Bayram, Ilhan Satman, Alper Sonmez, TEMD Study Group
Ibrahim Demirci, Cem Haymana, Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara 06190, Turkey
Serpil Salman, Department of Endocrinology and Metabolism, Liv Hospital, Istanbul 34000, Turkey
Ilker Tasci, Department of Internal Medicine, University of Health Sciences, Gulhane Faculty of Medicine, Ankara 06018, Turkey
Demet Corapcioglu, Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara 06560, Turkey
Ali Kirik, Department of Internal Medicine, Balıkesir University, Faculty of Medicine, Balikesir 10145, Turkey
İlhan Yetkin, Department of Endocrinology and Metabolism, Gazi University, Faculty of Medicine, Ankara 06190, Turkey
Mustafa Altay, Department of Endocrinology and Metabolism, Kecioren Training and Research Hospital, Ankara 06190, Turkey
Tevfik Sabuncu, Department of Endocrinology and Metabolism, Harran University, Faculty of Medicine, Sanliurfa 63050, Turkey
Fahri Bayram, Department of Endocrinology and Metabolism, Erciyes University, Faculty of Medicine, Kayseri 38000, Turkey
Ilhan Satman, Department of Endocrinology and Metabolism, Istanbul University, Faculty of Medicine, Istanbul 34000, Turkey
Alper Sonmez, Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Faculty of Medicine, Ankara 06190, Turkey
Author contributions: Demirci I and Haymana C collected data, performed the analyses and wrote the draft; Salman S, Corapcioglu D, Kirik A and Yetkin İ designed the research; Tasci I supervised the statistical analyses; Sabuncu T and Bayram F revised the manuscript; Altay M, Satman I and Sonmez A performed the research and wrote the paper; all TEMD Study Group members contributed to the database and re-check the manuscript and collaborators of the TEMD Obesity Study Group are listed in the online Supplementary material.
Institutional review board statement: The study was reviewed and approved by the TC Sağlık Bakanlığı Türkiye İlaç ve Tıbbi Cihaz Kurumu Institutional Review Board 93189304-514.11.01 E.58933.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mustafa Altay, MD, Chairman, Professor, Department of Endocrinology and Metabolism, Kecioren Training and Research Hospital, Yeşilevler mahallesi, 926. cadde, Markaevleri 2 sitesi C/14, Yenimahalle, Ankara 06190, Turkey. mustafa.altay@sbu.edu.tr
Received: May 12, 2021
Peer-review started: May 12, 2021
First decision: July 4, 2021
Revised: July 13, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: December 15, 2021
Processing time: 217 Days and 17.8 Hours
Abstract
BACKGROUND

Vaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.

AIM

To investigate the prevalence of influenza and pneumococcal vaccinations and to search for the independent associates of vaccination in Turkish patients with diabetes.

METHODS

In this cross-sectional, nationwide, multicenter study, adult patients with type 1 diabetes (T1DM) (n = 454) and type 2 diabetes (T2DM) (n = 4721), who were under follow-up for at least a year in the outpatient clinics, were consecutively enrolled. Sociodemographic, clinical, and laboratory parameters of patients were recorded. Vaccination histories were documented according to the self-statements of the patients.

RESULTS

Patients with T1DM and T2DM had similar vaccination rates for influenza (23.6% vs 21.2%; P = 0.240) and pneumococcus (8% vs 7%; P = 0.451) vaccinations. Longer diabetes duration and older age were the common independent associates of having vaccination for both types of diabetes patients. Higher education level, using statin treatment, and having optimal hemoglobin A1c levels were the common independent associates of influenza and pneumococcal vaccination in patients with T2DM.

CONCLUSION

TEMD Vaccination Study shows that patients with T1DM and T2DM had very low influenza and pneumococcal vaccination rates in Turkey. The lower rates of vaccination in certain populations urges the necessity of nationwide vaccination strategies targeting these populations.

Keywords: Diabetes; Influenza; Pneumococcus; Vaccination; Type 1 diabetes; Type 2 diabetes

Core Tip: The TEMD Vaccination Study is a cross-sectional, multicenter survey, which was carried out between April 1 and June 30, 2017, in 68 tertiary endocrine units from 37 cities throughout Turkey. The study revealed that the vaccination rates for pneumococcus and influenza were very low in patients with diabetes. Only 6.6% patients with type 1 diabetes (T1DM) and 5.8% patients with type 2 diabetes (T2DM) received both vaccines. Older age and longer diabetes duration were the common independent associates of vaccination in patients with T1DM and T2DM. The common independent associates of vaccination rates for T2DM were using statins, higher education and the lower hemoglobin A1c levels.