D'Addio Francesca, Lazzaroni Elisa, Lunati Maria Elena, Preziosi Giuseppe, Ercolanoni Michele, Turola Giulio, Marrocu Chiara, Cicconi Giovanni, Sharma Sudwaric, Scarioni Simona, Montefusco Laura, Pastore Ida, Morpurgo Paola Silvia, Rossi Antonio, Gandolfi Alessandra, Tinari Camilla, Rossi Giada, Ben Nasr Moufida, Loretelli Cristian, Fiorina Roberta Maria, Grassa Baldassarre, Terranova Rosa, Bucciarelli Loredana, Berra Cesare, Cereda Danilo, Zuccotti Gianvincenzo, Borriello Catia Rosanna, Fiorina Paolo
Division of Endocrinology, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy.
International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy.
J Clin Endocrinol Metab. 2025 Apr 22;110(5):e1590-e1597. doi: 10.1210/clinem/dgae476.
Type 1 (T1D) and type 2 diabetes (T2D) are associated with an elevated incidence of infectious diseases and a higher risk of infections-related hospitalization and death.
In this study, we delineated the "vaccinome" landscape obtained with a large immunization schedule offered by the Regional Government of Lombardy in a cohort of 618 396 patients with diabetes (T1D and T2D).
Between September 2021 and September 2022, immunization coverage for influenza, meningococcus, pneumococcus, and herpes zoster was obtained from the public computerized registry of the health care system of Lombardy Region (Italy) in 618 396 patients with diabetes and in 9 534 087 subjects without diabetes. Type of diabetes, age, mortality, and hospitalizations were retrospectively analyzed in vaccinated and unvaccinated patients.
Among patients with diabetes (T1D and T2D), 44.6% received the influenza vaccine, 10.9% the pneumococcal vaccine, 2.5% the antimeningococcus vaccine, and 0.7% the antizoster vaccine. Patients with diabetes immunized for influenza, zoster, and meningococcus showed a 2-fold overall reduction in mortality risk and a decrease in hospitalizations. A 3-fold lower risk of mortality and a decrease in hospitalizations for both cardiac and pulmonary causes were also observed after influenza, zoster, and meningococcus immunization in older patients with diabetes.
Immunization coverage is still far from the recommended targets in patients with diabetes. Despite this, influenza vaccination protected nearly 3800 per 100 000 patients with diabetes from risk of death. The overall impressive decrease in mortality and hospitalizations observed in vaccinated patients strengthens the need for scaling up the "vaccinome" landscape in patients with diabetes.
1型糖尿病（T1D）和2型糖尿病（T2D）与传染病发病率升高以及感染相关住院和死亡风险较高有关。
在本研究中，我们描绘了意大利伦巴第大区政府提供的大型免疫接种计划在618396例糖尿病患者（T1D和T2D）队列中所获得的“疫苗接种图谱”。
2021年9月至2022年9月期间，从意大利伦巴第大区医疗保健系统的公共计算机登记系统中获取了618396例糖尿病患者和9534087例非糖尿病患者的流感、脑膜炎球菌、肺炎球菌和带状疱疹疫苗接种覆盖率。对已接种和未接种疫苗的患者的糖尿病类型、年龄、死亡率和住院情况进行了回顾性分析。
在糖尿病患者（T1D和T2D）中，44.6%接种了流感疫苗，10.9%接种了肺炎球菌疫苗，2.5%接种了抗脑膜炎球菌疫苗，0.7%接种了抗带状疱疹疫苗。接种流感、带状疱疹和脑膜炎球菌疫苗的糖尿病患者总体死亡风险降低了两倍，住院率也有所下降。在老年糖尿病患者中，接种流感、带状疱疹和脑膜炎球菌疫苗后，死亡风险降低了三倍，心脏和肺部疾病导致的住院率也有所下降。
糖尿病患者的疫苗接种覆盖率仍远低于推荐目标。尽管如此，流感疫苗接种使每10万名糖尿病患者中近3800人免受死亡风险。在接种疫苗的患者中观察到的死亡率和住院率总体显著下降，强化了扩大糖尿病患者“疫苗接种图谱”的必要性。
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