Department of Endocrinology, Peking University First Hospital, Beijing, China.
iHealth Labs China Co.,Ltd, Beijing, China.
BMC Endocr Disord. 2022 Dec 23;22(1):329. doi: 10.1186/s12902-022-01201-5.
The study aimed to investigate the attitudes of people with diabetes mellitus (DM) on COVID-19 vaccination and its influence on the glycemic control.
Data were collected from a consecutive series of adults (age > 18 years) with type 2 diabetes under regular follow-ups in the Integrated Care Diabetes Outpatient Clinic of Peking University First Hospital from December 1 to December 31 2021. An online interview questionnaire was conducted, and demographic data including age, sex category, history of drug allergy, history of hypertension, the duration of diabetes, reasons for vaccine hesitancy (VH) and adverse reactions after each injection of vaccines was collected. Glucose levels were collected from medical records.
Thirty-nine (22.9%) subjects experienced VH and 131 (77.1%) people living with diabetes received inactivated vaccine against COVID-19. Hesitant individuals had a higher proportion of female gender (vaccinated group vs. VH group, 62/131 vs. 26/39, p = 0.044), higher baseline glycosylated hemoglobin A (HbA) (vaccinated group vs. VH group, 6.56 ± 0.95% vs. 7.54 ± 2.01%, p < 0.001) and elevated baseline postprandial blood glucose (PBG) (vaccinated group vs. VH group, 8.32 ± 1.97 mmol/L vs. 9.44 ± 2.94 mmol/L, p = 0.015). Subjects of male gender (p = 0.025) and history of hypertension (p = 0.021) were likely to get vaccinated, while higher HbA1c was negatively associated with an elevated propensity to receive anti-COVID-19 vaccine (p = 0.003). Most common reasons for hesitating to receive COVID-19 vaccination were worrying about the possibility of leading to other diseases (30.8%), followed by fearing of glucose variation (17.9%). Systemic adverse reactions were reported in 30.5% individuals after the first injection of inactivated vaccines, and resolved within 3 days in medium. Fasting blood glucose (FBG) decreased significantly after the third injection compared with FBG after the second dose (second vs. third, 6.78 ± 1.24 mmol/L vs. 6.41 ± 1.30 mmol/L, p = 0.027). HbA reduced significantly from 6.56% before vaccination to 6.35% after the second injection (p = 0.012).
Our study demonstrated that vaccine hesitancy was lower among male subjects and people with hypertension, while vaccine confidence was reduced in people with poor glycemic control. HbA level was lower along with vaccination.
本研究旨在探讨糖尿病患者（DM）对 COVID-19 疫苗接种的态度及其对血糖控制的影响。
本研究于 2021 年 12 月 1 日至 12 月 31 日期间，连续收集了在北京大学第一医院综合糖尿病门诊接受常规随访的成年患者（年龄>18 岁）的数据。通过在线访谈问卷收集了人口统计学数据，包括年龄、性别、药物过敏史、高血压史、糖尿病病程、疫苗犹豫（VH）的原因以及每次接种疫苗后的不良反应。血糖水平从病历中收集。
39 名（22.9%）患者存在 VH，131 名（77.1%）糖尿病患者接受了 COVID-19 灭活疫苗接种。犹豫的患者中女性比例更高（接种组 vs. VH 组，62/131 vs. 26/39，p=0.044），基线糖化血红蛋白 A（HbA）水平更高（接种组 vs. VH 组，6.56±0.95% vs. 7.54±2.01%，p<0.001），餐后血糖（PBG）水平更高（接种组 vs. VH 组，8.32±1.97mmol/L vs. 9.44±2.94mmol/L，p=0.015）。男性（p=0.025）和高血压史（p=0.021）的患者更有可能接种疫苗，而较高的 HbA1c 与接种抗 COVID-19 疫苗的意愿降低呈负相关（p=0.003）。拒绝接种 COVID-19 疫苗的最常见原因是担心接种疫苗可能导致其他疾病（30.8%），其次是担心血糖变化（17.9%）。30.5%的人在接种灭活疫苗第一针后出现全身不良反应，中等程度的不良反应在 3 天内缓解。与第二次注射相比，第三次注射后空腹血糖（FBG）显著降低（第二次 vs. 第三次，6.78±1.24mmol/L vs. 6.41±1.30mmol/L，p=0.027）。接种疫苗后，HbA 从接种前的 6.56%显著降低至第二次注射后的 6.35%（p=0.012）。
本研究表明，男性和高血压患者的疫苗犹豫率较低，而血糖控制不佳的患者对疫苗的信心较低。HbA 水平随着接种而降低。
