Working-age adults with diabetes experience greater susceptibility to seasonal influenza: A population-based cohort study
Open accessAbstract
Aims/hypothesis The aim of this work was to compare the incidence of illness attributable to influenza in working-age adults (age <65 years) with and without diabetes.Methods We performed a cohort study using administrative data from Manitoba, Canada, between 2000 and 2008. All working-age adults with diabetes were identified and matched with up to two non-diabetic controls. We analysed the rates of influenza-like illness physician visits and hospitalisations, pneumonia and influenza hospitalisations, and all-cause hospitalisations. Multivariable regressions were used to estimate the influenza-attributable rate of each outcome.Results We included 745,777 person-years of follow-up among 166,715 subjects. The median age was 50-51 years and 48-49% were women; adults with diabetes had more comorbidities and were more likely to be vaccinated for influenza than those without diabetes. Compared with similar adults without diabetes, those with diabetes had a 6% greater (RR 1.06, 95% CI 1.02, 1.10; absolute risk difference 6 per 1,000 adults per year) increase in all-cause hospitalisations associated with influenza, representing a total of 54 additional hospitalisations. There were no differences in the influenza-attributable rates of influenza-like illness (p = 0.06) or pneumonia and influenza (p = 0.11).Conclusions/interpretation Guidelines calling for influenza vaccinations in diabetic, in addition to elderly, adults implicitly single out working-age adults with diabetes. The evidence supporting such guidelines has hitherto been scant. We found that working-age adults with diabetes appear more susceptible to serious influenza-attributable illness. These findings represent the strongest available evidence for targeting diabetes as an indication for influenza vaccination, irrespective of age.
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Large population-based cohort studies found pioglitazone associated with a modestly increased risk of bladder cancer compared with other oral diabetes therapies, including rosiglitazone as comparator.
“Large population-based cohort studies have found that pioglitazone is associated with a modestly increased risk of bladder cancer when compared with other oral DM therapies including the TZD rosiglitazone as the comparator.1802,1803”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1803]
The Subjects and Results passages describe a cohort comparing influenza-related outcomes in adults with and without diabetes, not diabetes therapies or bladder cancer. Searches for pioglitazone, rosiglitazone, bladder cancer, and oral diabetes therapies found no passage addressing the claimed association. (LLM, conf=0.76)
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- Authors
- Lau, D., Eurich, D. T., Majumdar, S. R., Katz, A., & Johnson, J. A.
- Affiliations
- University of Alberta (CA)
- University of Manitoba (CA)
- Corresponding author
- Johnson, Jeffrey A.
- Venue
- Diabetologia
- Published
- 2014-02-06
- Volume
- 57
- Issue
- 4
- Pages
- 690-698
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2024582411
- Cited by
- 41
- References
- 48
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 6 · 2017: 5 · 2015: 3
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Alberta Innovates - Health Solutions
- University of Alberta
- Alberta Innovates
- Canadian Institutes of Health Research (119316_1)
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Keywords
- diabetes mellitus, seasonal influenza, influenza susceptibility, working-age adults, influenza hospitalization, influenza-like illness, influenza vaccination, comorbidities
- MeSH terms
- Adult, Diabetes Mellitus, Female, Humans, Influenza, Human, Male, Middle Aged, Seasons, Cohort Studies, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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