Viral Hepatitis

Diabetes and Hepatitis B

Key Facts about Diabetes and Hepatitis B

People living with type 1 or type 2 diabetes mellitus have higher rates of hepatitis B than the general population.
People living with diabetes are at increased risk for hepatitis B if they share blood glucose meters, fingerstick devices or other diabetes-care equipment such as syringes or insulin pens.
Transmission of hepatitis B has occurred among people with diabetes who reside in assisted living facilities when several people received glucose monitoring in close succession.

Hepatitis B Vaccine Recommendation for People with Diabetes

CDC and ACIP recommend Hepatitis B vaccination for all:

Unvaccinated adults with diabetes who are younger than 60 years of age.
- Vaccination should occur as soon as possible after diagnosis of diabetes;
- Vaccination should also be given to adults diagnosed with diabetes in the past.

ACIP recommends:

Hepatitis B vaccination occur at the discretion of the health care provider for unvaccinated adults with diabetes who are 60 years and older.

Rationale for the Recommendation

CDC has investigated numerous hepatitis B outbreaks in people with diabetes in assisted living, long-term care facilities and nursing homes. Modes of transmission are believed to have occurred from:

Use of blood glucose meter for more than one resident without cleaning and disinfection between uses
Failure to consistently wear gloves and perform hand hygiene between fingerstick procedures
Use of the same fingerstick devices for more than one resident
Cross-contamination of clean supplies with contaminated blood glucose monitoring equipment used by home health agencies
Use of the same injection equipment such as a syringe or insulin pen for more than one person
Failure to maintain separation of clean and contaminated podiatry equipment
Improper sterilization of contaminated podiatry equipment
Failure to perform environmental cleaning and disinfection between podiatry patients

Scientific Guidelines and Recommendations

Use of Hepatitis B Vaccination for Adults with Diabetes Mellitus: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR 2011;60(50);1709-1711 [PDF - 32 pages]