Influenza vaccination coverage in patients with diabetes mellitus afferent to an Italian hospital

Background

Patients with type 1 (T1DM) and type 2 (T2DM) diabetes are at increased risk of vaccine-preventable diseases and their complications. The National Vaccinal Prevention Plan 2017-2019 includes specific recommendations for patients with diabetes, which in 2018 have been included in the standards of care of the Italian Diabetes Society (SID) and Italian Association of Clinical Diabetologists (AMD).

Methods

Adult diabetic patients attending the Diabetes clinic at the San Raffaele Hospital, a large teaching hospital in Milan, Italy, were surveyed with a questionnaire to investigate self-reported vaccinal history, knowledge, attitudes and practice on the recommended vaccinations, vaccinal hesitancy and information sources on the topic.

Results

Between May 16 and November 11, 2019 N = 222 T1DM and N = 57 T2DM patients were enrolled. 25.2% of T1DM and 26.3% of T2DM patients did get vaccinated annually against the flu in the past 3 year. 85.0% of T2DM patients were vaccinated at the General Practitioner's (GP) clinic, while 54.9% of T1DM patients were vaccinated by their GP and 24.4% from territorial vaccinal clinics. 54.5% of T1DM and 50.0% of T2DM patients chose not to be vaccinated because they didn't consider the vaccine useful, while the second most common reason was that they have not been advised by healthcare personnel.

Conclusions

We documented a low coverage and knowledge about influenza vaccination. Patients with diabetes trusted information and advice of diabetologists and GPs about vaccination and claimed that they would be more likely to vaccinate if vaccination were offered in the diabetes clinic. Implementing training programs for professionals and educational campaigns for patients with diabetes may improve vaccinal coverage.

Key messages

Vaccination coverage in T1DM and T2DM patients is low due to vaccination hesitancy. A strong action from care givers, in order to raise vaccination awareness in this at-risk population, is needed.

Luminescent chains formed from neutral, triangular gold complexes sandwiching TlI and AgI. Structures of (Ag([Au(mu-C2,N3-bzim)]3)2)BF4.CH2Cl2, (Tl([Au(mu-C2,N3-bzim)]3)2)PF(6).0.5THF (bzim = 1-benzylimidazolate), and (Tl([Au(mu-C(OEt)=NC6H4CH3)]3)2)PF6.THF, with MAu6 (M = Ag+, Tl+) cluster cores

It has been found that several trinuclear complexes of AuI interact with silver and thallium salts to intercalate Ag+ and Tl+ cations, thereby forming chains. The resulting sandwich clusters center the cations between the planar trinuclear moieties producing structures in which six AuI atoms interact with each cation in a distorted trigonal prismatic coordination. The resultant (B3AB3B3AB3)infinity pattern of metal atoms also shows short (approximately 3.0 A) aurophilic interactions between BAB molecular centers. These compounds display a strong visible luminescence, under UV excitation, which is sensitive to temperature and the metal ion interacting with the gold. X-ray crystal structures are reported for Ag([Au(mu-C2,N3-bzim)]3)2BF4CH2Cl2 (P1, Z = 2, a = 14.4505(1) A; b = 15.098(2)A; c = 15.957(1)A; alpha = 106.189(3) degrees; beta = 103.551(5) degrees; gamma = 101.310(5) degrees); Tl([Au(mu-C2,N3-bzim)]3)2PF(6)05C4H8O (P1, Z = 2, a = 15.2093(1)A; b = 15.3931(4)A; c = 16.1599(4)A; alpha = 106.018(1) degrees; beta = 101.585(2) degrees; gamma = 102.068(2) degrees); and Tl([Au(mu-C(OEt)=NC6H4CH3)]3)2PF6.C4H8O (P2(1)/n, Z = 4, a = 16.4136(3)A; b = 27.6277(4)A; c = 16.7182(1)A; beta = 105.644(1) degrees). Each compound shows that the intercalated cation, Ag+ or Tl+, coordinates to a distorted trigonal prism of six AuI atoms. The counteranions reside well apart from the cations between the cluster chains.