Title : Vaccines for diabetes and associated infections in diabetic patients
Abstract:
Diabetes is a metabolic chronic disease characterized by elevated blood glucose levels over a prolonged period which occurs either when the pancreas does not produce enough insulin or the human’s body cannot effectively use the insulin it produces. Worldwide, 590 million people are suffering with diabetes and is projected to reach 853 million by 2050 (IDF Diabetes Atlas 2025). It has caused an estimated 3.4 million global deaths in the year 2024, representing 9.3% (or 1 in 11) of all- caused global mortality among adults (WHO 2025).
Diabetes causes functional immunosuppression which impairs immune cell function, reduces neutrophil phagocytosis, mainly reducing T-cell function and altered cytokines, thereby weakening the response to infections by fungi, viruses and bacteria. The risk of mycoses increases 1.38-fold in diabetic patients Mao 2019. Candidiasis (oral and vaginal), dermatophytosis (ring worms, onychomycosis) and invasive mycoses (rhino - orbital-cerebral mucormycosis, aspergillosis, cryptococcosis, histoplasmosis and candidemia) are the major mycoses among diabetics. Common superficial mucosal involvement (candidiasis) often serves as an early marker of immune dysregulation, to rapidly progressive, life-threatening deep invasive fungal infections, such as mucormycosis representing catastrophic sequence of uncontrolled diabetes. There are no vaccines for mycoses. They can be prevented and treated by maintaining tight glycaemic control, strict hygiene, wearing breathable (cotton) clothes, foot care and antifungal topical or oral medications.
Vaccines for diabetic patients are crucial for preventing serious complications from infections. Major vaccines that cover the most common and dangerous infections in diabetics include: Annual flu (influenza) vaccine, Hepatitis-B vaccine, pneumococcal vaccine, shingles (herpes-zoster) vaccine, Tdap vaccine, COVID-19 vaccine, and RSV vaccine.
Significant progress has been made towards developing vaccines to delay or prevent the onset of diabetes entirely. About 11 vaccines based upon five approaches (alum adjuvant- based, protein- based, specific self -antigen based, non-antigen based and other disease- based vaccine) has been developed, which are mostly studied on animal models. GAD 65 vaccine (Intralymphatic GAD-Alum vaccine, Diamyd®), a specific self-antigen derived vaccine, has been proved to be effective in managing glucose and halting diabetes type-1 progression in patients aged 12-24. This vaccine targets at self-reactive T-cells (GAD 65). GAD is a protein fragment located in the insulinproducing β-cells found in the pancreas responsible for destroying islet cells. No vaccine cures diabetes and has not yet been approved for public use.
The diabetes vaccine comes as a remarkable solution in the field of medical science which calls for laying emphasis on continuous research, human's trials and innovations to realize such pioneer remedy for diabetic patients, including searches for vaccines against the fatal mycoses, saving lives of millions of youths in the coming years.
