India has 101 million people with diabetes: Why doctors say the flu vaccine matters

India's diabetes burden continues to grow at an alarming pace. According to the ICMR INDIAB study, nearly 101.3 million adults in the country are living with diabetes. At the same time, another 136 million are estimated to have prediabetes and remain at high risk of developing the condition. As the burden of diabetes rises, so does the need to look beyond blood glucose management alone and focus on strategies that help prevent avoidable complications.

For most people, diabetes management revolves around monitoring blood glucose levels, following a healthy diet, staying physically active, and taking medications as prescribed. While these remain essential pillars of care, protecting against infectious diseases such as influenza is an important, yet often overlooked, part of diabetes management.

Influenza is commonly viewed as a temporary seasonal illness. However, for people living with diabetes, it can have far more serious consequences. The condition places additional stress on the body at a time when the immune system may already be compromised, making it harder to fight infection and recover quickly. During illness, the release of stress hormones can cause blood glucose levels to rise unpredictably, disrupting glycaemic control and increasing the risk of diabetes-related complications.

The risk is particularly significant for individuals with HbA1c levels above 8 per cent and those living with diabetes-related macrovascular or microvascular complications. These patients are more vulnerable to severe illness, hospitalization and poorer health outcomes following influenza infection.

Studies continue to highlight the impact influenza can have on people living with diabetes. Research has shown that individuals with diabetes who receive an influenza vaccine experience lower rates of hospitalisation due to pneumonia and reduced mortality compared with those who remain unvaccinated. Indian data further reinforce these findings, showing that people with T2DM who develop influenza have a two-fold higher risk of mortality, a three-fold higher risk of hospitalization and a four-fold higher risk of intensive care unit admission compared with those without influenza infection.

The role of vaccination in diabetes care

These findings highlight an important reality: for people with diabetes, preventing influenza can be just as important as treating it. Annual influenza vaccination is recommended as a key preventive strategy, particularly for individuals with poorly controlled diabetes and those with diabetes-related vascular complications.

While vaccination does not replace healthy lifestyle habits, regular monitoring, or medication adherence, it complements these measures by helping reduce the risk of an infection that can destabilize overall health and diabetes control.

Diabetes management

The benefits of vaccination extend beyond protection against influenza alone. By helping prevent severe infection, vaccination may contribute to more stable glycaemic control, fewer diabetes-related disruptions and reduced health care utilisation.

Avoiding influenza-related illness can mean fewer hospital admissions, fewer interruptions to treatment plans and less physical stress on the body. For many individuals, it can also provide greater confidence in managing diabetes without the added burden of a preventable infection.

As health care professionals, we increasingly recognise that diabetes care is not only about managing blood sugar levels but also about preventing complications wherever possible. Immunisation should therefore be viewed as an important component of comprehensive diabetes care, alongside nutrition, physical activity, medication adherence and regular health monitoring.

Looking beyond blood glucose control

As India's diabetes burden continues to rise, greater awareness of adult immunisation is essential. Encouraging timely influenza vaccination among people living with diabetes can play an important role in reducing illness, preventing complications and supporting better long-term health outcomes.

Ultimately, effective diabetes management means looking beyond glucose numbers alone and embracing preventive measures that help individuals stay healthier, avoid hospitalisations and lead more resilient lives throughout the year.

(The author is a diabetologist specialising in diabetes management, metabolic health, and diabetes-related complications)

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.