Diabetes is one of the leading non-communicable diseases (NCDs) in the Philippines, with nearly 5 million Filipino adults diagnosed with the condition. In 2024, diabetes ranked as the fifth leading cause of death nationwide.
This chronic disease occurs when the body cannot produce or effectively use insulin. Left uncontrolled, diabetes can lead to devastating complications such as blindness, kidney failure, heart attack, stroke, and lower limb amputation.
As the country marks “Diabetes Awareness Week,” it is timely to highlight five key steps in managing the disease. First, engage in regular physical activity. Second, follow a healthy, low-fat, low-salt, fiber-rich diet. Third, take prescribed maintenance medications, including insulin, as prescribed by your doctor. Fourth, see your doctor regularly. Finally, stay up to date with your vaccinations.
Vaccination plays a vital yet often underappreciated role in diabetes management. People with diabetes have weakened immune responses, making them more vulnerable to infections. High blood sugar levels impair immune function and hinder the body’s ability to fight off disease-causing pathogens.
Respiratory infections, in particular, pose a serious risk. These can trigger spikes in blood sugar that may require hospitalization. Studies show that people with diabetes are twice as likely to die from influenza and more than four times more likely to develop pneumococcal disease compared to those without diabetes.
To address these risks, the Philippine Society of Endocrinology, Diabetes, and Metabolism (PSEDM) recommends the following vaccines for adults with diabetes: influenza vaccine, pneumococcal vaccine, Tdap (tetanus, diphtheria, pertussis) vaccine, hepatitis B vaccine, and herpes zoster (shingles) vaccine.
Vaccines have a measurable impact on health outcomes in people with diabetes. For example, flu vaccination has been shown to reduce flu- and diabetes-related hospitalizations. One study found that individuals with diabetes who received a seasonal flu shot were 66% less likely to require flu-related medical care.
Likewise, the pneumococcal vaccine helps prevent serious infections such as bacteremia (bacteria in the blood) and meningitis. Immunized individuals with diabetes have a lower risk of hospitalization or death due to pneumococcal disease.
Hepatitis B is another concern. People with diabetes face higher rates of hepatitis B infection, possibly due to shared glucose monitoring equipment or reduced immune protection. PSEDM recommends hepatitis B vaccination for diabetic adults under 60, and at a doctor’s discretion for those aged 60 and above.
Finally, the herpes zoster virus causes shingles, which tends to be more severe and prolonged in people with diabetes. They also have a higher risk of developing post-herpetic neuralgia, a painful condition that can last long after the shingles rash disappears. The recombinant zoster vaccine is recommended for those with diabetes aged 50 and older.
While vaccines are typically associated with infectious disease prevention, they also play a critical role in reducing the burden of chronic diseases like diabetes. Preventing infections in this population reduces complications, hospitalizations, and strain on the healthcare system.
This broader value of immunization is underscored in a 2022 policy report titled “From Protection to Prevention: The Power of Immunizing People Living with Diabetes” by the Health Policy Partnership, a UK-based research organization. Funded by the International Federation of Pharmaceutical Manufacturers and Associations, the report outlines a roadmap to protect individuals, health systems, and economies through adult immunization.
The study offers four strategic policy priorities. First is enable innovation by embedding vaccination into standard diabetes care pathways; and using innovative outreach and delivery models.
Second is mobilize investment by allocating prevention budgets to support adult immunization; and investing in data-driven approaches to maximize impact.
Third is drive implementation by increasing public awareness among people with NCDs.
It is also crucial to equip healthcare workers to provide consistent vaccine guidance, and to remove barriers to vaccine access.
Fourth is to ensure accountability by integrating immunization targets into national NCD frameworks. It is equally important to strengthen data systems to track and improve outcomes.
As we reflect on the toll of diabetes in the Philippines, we must expand our view of what it means to manage chronic illness. Vaccination is preventive care, not optional care, especially for those whose health is already compromised.
By protecting people with diabetes through timely immunization, we not only reduce their risk of serious infection, but also strengthen public health, reduce healthcare costs, and build a more resilient society.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.
