Awareness of diabetic adult patients about immunization

Main Article Content

Muhammet Zahid Оncu
Ali Timucin Аtayoglu
Hakan Sari
Murat Аltuntas


Background. Diabetes mellitus (DM) is associated with an increased rate of infection, which was partly explained by a decreased T cell-mediated response, and although being controversial, impaired function of neutrophil associated with diabetes is also documented. The purpose was to determine awareness of type 2 Diabetic patients about immunization against hepatitis-B, influenza, tetanus and zona, to find out the source of current vaccine information. Materials and methods. The study was planned as a single centred, prospective, cross-sectional, descriptive and analytical trial. The questionnaire form was applied to patients diagnosed with type 2 DM, who applied to Diabetics Outpatient Clinic by face-to-face interview technique. Results. A total of 439 patients was evaluated; the diagnosis time of 38.5, 19, 24 and 18 % of the patients was determined as 0–5 years, 6–10 years, 11–15 years and more than 16 years, respectively. Organ damage was detected in 76 of the patients, and as the most common complication, retinopathy was found to be in 57 (13.01 %) patients. Among the patients, 175 (39.86 %) of them had coexisting hypertension, and 164 (37.36 %) of them had coexisting hyperlipidaemia. Whereas 153 (35.75 %) were aware of pneumococcal vaccine, the number of patients who got vaccinated was 55 (12.53 %). Whereas 336 (76.54 %) were aware of influenza vaccine, 108 (24.60 %) of them got vaccinated. Among the patients, 179 (40.77 %) heard of hepatitis B vaccine, but 34 (7.74 %) got vaccinated. It was determined that, 279 people heard od tetanus vaccine, 183 people were administered at least one dose of vaccine, however the last vaccine of 101 (55.49 %) of those who had tetanus vaccine, was more than 11 years ago. Only 3 out of 33 (7.52 %), who knew about the zona vaccine, got vaccinated. In that study, 243 (55.35 %) people got vaccinated in adulthood for any reason. There was no significant relationship between education level and duration of disease and vaccination. Conclusions. Adult immunization rates of diabetic patients were found to be in low levels. The primary care professionals play an essential role in the immunization of diabetic patients.

Article Details

How to Cite
Zahid Оncu M., Timucin Аtayoglu A., H. Sari, and Аltuntas M. “Awareness of Diabetic Adult Patients about Immunization”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 17, no. 4, Sept. 2021, pp. 273-9, doi:10.22141/2224-0721.17.4.2021.237339.
Original Researches


Qaseem A, Barry MJ, Humphrey LL, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From the American College of Physicians. Ann Intern Med. 2017 Feb 21;166(4):279-290. doi: 10.7326/M16-1860.

International Diabetes Federation. IDF Diabetes Atlas - 8th Edition. 2017.

Muller LM, Gorter KJ, Hak E, et al. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis. 2005 Aug 1;41(3):281-8. doi: 10.1086/431587.

Lampasona V, Secchi M, Scavini M, et al. Antibody response to multiple antigens of SARS-CoV-2 in patients with diabetes: an observational cohort study. Diabetologia. 2020 Dec;63(12):2548-2558. doi: 10.1007/s00125-020-05284-4.

Jiménez-Garcia R, Lopez-de-Andres A, Hernandez-Barrera V, et al. Influenza vaccination in people with type 2 diabetes, coverage, predictors of uptake, and perceptions. Result of the MADIABETES cohort a 7years follow up study. Vaccine. 2017 Jan 3;35(1):101-108. doi: 10.1016/j.vaccine.2016.11.039.

American Association of Diabetes Educators. Vaccination practices for hepatitis B, influenza, and pneumococcal disease for people with diabetes. Diabetes Educ. 2014 Jan-Feb;40(1):122-4. doi: 10.1177/0145721713513545.

Diabetes Canada Clinical Practice Guidelines Expert Committee, Husein N, Chetty A. Influenza, Pneumococcal, Hepatitis B and Herpes Zoster Vaccinations. Can J Diabetes. 2018 Apr;42 Suppl 1:S142-S144. doi: 10.1016/j.jcjd.2017.10.016.

Ozisik L, Tanriover MD, Rigby S, Unal S; European Federation of Internal Medicine ADVICE Working Group. ADVICE for a healthier life: Adult Vaccination Campaign in Europe. Eur J Intern Med. 2016 Sep;33:14-20. doi: 10.1016/j.ejim.2016.04.021.

Mantel C, Cherian T. New immunization strategies: adapting to global challenges. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2020 Jan;63(1):25-31. doi: 10.1007/s00103-019-03066-x.

Biberoğlu K, Biberoğlu S, Özbakkaloğlu M, et al. Haydi Büyükler Aşıya. Available from: Accessed: April 4, 2021.

Arslan EI, Altınova A, Baloş Törüner F, et al. Diyabetik Hastaların Hepatit-B, İnfluenza ve Pnömokok Aşı Farkındalıkları. Gazi Medical J. 2016;27(3):115-117.

Satman I, Akalin S, Cakir B, Altinel S; diaVAX Study Group. The effect of physicians' awareness on influenza and pneumococcal vaccination rates and correlates of vaccination in patients with diabetes in Turkey: an epidemiological Study "diaVAX". Hum Vaccin Immunother. 2013 Dec;9(12):2618-26. doi: 10.4161/hv.25826.

Looijmans-Van den Akker I, Verheij TJ, Buskens E, Nichol KL, Rutten GE, Hak E. Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients. Diabetes Care. 2006 Aug;29(8):1771-6. doi: 10.2337/dc05-2517.

Heymann AD, Shapiro Y, Chodick G, et al. Reduced hospitalizations and death associated with influenza vaccination among patients with and without diabetes. Diabetes Care. 2004 Nov;27(11):2581-4. doi: 10.2337/diacare.27.11.2581.

Uzuner A, Arabacı Ş, Yüceel A, Kocatürk A, Kaynar E, Khan A. Erişkinlerin Erişkin Aşıları Hakkındaki Bilgi, Tutum ve Davranışları. Turkish Journal of Family Medicine and Primary Care. 2018;12(3):215-225 . doi: 10.21763/tjfmpc.452487.

Norton SP, Scheifele DW, Bettinger JA, West RM. Influenza vaccination in paediatric nurses: cross-sectional study of coverage, refusal, and factors in acceptance. Vaccine. 2008 Jun 2;26(23):2942-8. doi: 10.1016/j.vaccine.2008.03.033.

Sarı T, Temoçin F, Köse H. Attitudes of Healthcare Workers Towards Influenza Vaccine. Klimik Dergisi. 2017;30:59-63. doi: 10.5152/kd.2017.15.

Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. MMWR Morb Mortal Wkly Rep. 2018;67:103-108. doi: 10.15585/mmwr.mm6703a5external icon.

Joon Lee T, Hayes S, Cummings DM, et al. Herpes zoster knowledge, prevalence, and vaccination rate by race. J Am Board Fam Med. 2013 Jan-Feb;26(1):45-51. doi: 10.3122/jabfm.2013.01.120154.

Toprak D, Koksal I. Adult vaccination, problems in practice and solution proposals, role of family physicians in adult vaccination. Turk Aile Hek Derg. 2018;22(3):166-174. doi: 10.15511/tahd.18.00366.