I am a 50 year old female. I have been diagnosed with Diabetes 7 years ago. My HbA1c is 7.2. My doctor has recommended me to take yearly vaccines. I don’t fall ill very frequently. Why is vaccination important?
Every year, thousands of adults get sick from fatal diseases that could have been prevented by vaccination. Among them, people with Diabetes are particularly at higher risk for serious problems as high blood sugar levels can weaken the immune system. In addition, some Diabetes-related health issues such as nerve damage and reduced blood flow to the extremities increase the body’s vulnerability to infection. So even though your blood sugar levels are well controlled and you don’t fall ill very frequently, you may be at risk for serious complications from an illness compared to people without diabetes.
CDC (Centers for Disease Control and Prevention) recommends following vaccination in people with Diabetes.
- Influenza vaccine – To protect against seasonal flu, this vaccine is given as single intramuscular dose of 0.5 ml every year
- Pneumococcal vaccine
This vaccine protects against serious pneumococcal diseases. One dose of pneumococcal vaccine should be administered before the age of 65 years and two more doses afterwards.
- Tdap vaccine – Tetanus booster should be administered every 10 years to protect against tetanus, diphtheria, and whooping cough.
- Hepatitis B vaccine – Protects against Hepatitis B infection, which affects the liver and can lead to serious health issues such as cirrhosis and liver cancer. Hepatitis B vaccine should be administered minimum 3 doses for unvaccinated adults under the age of 60 years.
- Zoster vaccine – To protect against shingles, 2 doses of zoster vaccine should be taken minimum 1 month apart for people age 50 years and
The side effects of vaccines are usually mild and go away on their own and severe side effects are very rare. So, apart from considering conventional micro and macro vascular events, infections also have significant importance in diabetes, thus better to get protected by vaccination, as rightly said “Prevention is better than Cure“.
Dr Ashutosh Pakale
Consultant Physician
I am a 32-year-old male. I take medication for high blood pressure. My doctor has advised me of home monitoring of blood pressure. Why is it important? Also please explain about ambulatory blood pressure monitoring.
The normal blood pressure range is 120/80 mm Hg. Hypertension is a blood pressure measurement when the systolic (upper) blood pressure is at or above 140 mm Hg and the diastolic (lower) blood pressure is at or above 90 mm Hg. Usually, only one or two readings are taken during a doctor’s visit with an instrument called a sphygmomanometer. However, in ambulatory BP monitoring, readings are taken every 20 to 30 minutes during the day and night. So it is continuous monitoring of blood pressure over a 24-
hour period, whether the person is awake or asleep. It consists of a small digital blood pressure recording machine and a Velcro cuff. The machine is attached to a belt and is worn around the body and while the cuff is wrapped around the upper arm.
Abnormal fluctuations in blood pressure might occur due to daily activities, sleep and in conditions like white coat hypertension, masked hypertension, and sustained hypertension. When only one or two readings are taken during a doctor’s visit such fluctuations might not be detected. Some people have elevated blood pressure readings when taken at a doctor’s clinic is known as white coat hypertension. This can result in misdiagnosis of hypertension whose blood pressure is otherwise normal. In masked hypertension, a person’s blood pressure reading is normal at the doctor’s office but is elevated when he or she is at home. Sustained hypertension refers to BP readings that are elevated whether the patient is in the doctor’s clinic or at home. All these scenarios may lead to a misdiagnosis which may cause further complications, especially in Diabetes.
Some of the advantages of ambulatory blood pressure monitoring are:
- It helps correlate changes in blood pressure with daily activities and to detect nocturnal hypertension or loss of blunted or abolished overnight dips in blood pressure.
- It prevents misdiagnosis of white coat
- It helps detect masked hypertension so that incidence of stroke, heart disease and organ damage due to high blood pressure can be reduced.
- It helps evaluate a person’s response to long-acting antihypertensive
Dr Sudeep Jain
Consultant Physician
