Shingles and diabetes are common health conditions, and individuals often wonder if there is a direct link between them. Diabetes does not directly cause shingles, but it significantly increases a person’s risk of developing the condition by affecting the immune system.
Understanding Shingles and Diabetes
Shingles, also known as herpes zoster, is a viral disease characterized by a painful skin rash with blisters. It is caused by the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After a person recovers from chickenpox, VZV remains dormant in nerve cells and can reactivate years later, causing shingles. The rash typically appears as a stripe of fluid-filled blisters on one side of the body or face, often accompanied by burning pain, tingling, or itching.
Diabetes is a chronic condition that affects how the body regulates blood sugar, also known as glucose. In type 1 diabetes, the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin production. Type 2 diabetes occurs when the body either does not produce enough insulin or does not use insulin effectively, a condition called insulin resistance. Both types of diabetes can lead to chronically high blood sugar levels, which can impact various bodily systems.
How Diabetes Increases Shingles Risk
Diabetes, particularly when blood sugar levels are not well-controlled, can compromise the immune system, making individuals more susceptible to infections like shingles. High blood sugar can impair the function of immune cells, including T-cells, which are important for fighting off viruses. A weakened immune system is less effective at keeping the dormant varicella-zoster virus in check, thereby increasing the likelihood of its reactivation and the development of shingles.
Chronic low-grade inflammation is often associated with diabetes, which can further stress the immune system. This ongoing inflammation can contribute to immune cell dysfunction, creating an environment that is less able to suppress the varicella-zoster virus and prevent its reactivation.
Both increasing age and the presence of diabetes are independent risk factors for developing shingles. The risk of shingles naturally increases with age as the immune system weakens over time. When diabetes is present, it adds another layer of immune compromise, further elevating the risk of VZV reactivation and shingles development. Studies indicate that shingles is about 20% more common in individuals with diabetes compared to those without the condition.
Preventing and Managing Shingles with Diabetes
Vaccination is a highly effective preventive measure against shingles for individuals with diabetes. The recombinant zoster vaccine (RZV), known as Shingrix, is recommended for adults aged 50 and older, and also for adults 19 and older with weakened immune systems due to disease or therapy. This two-dose vaccine series is over 90% effective at preventing shingles in adults 50 years and older with healthy immune systems, and between 68% and 91% effective in preventing shingles in adults with weakened immune systems, depending on their condition. Even if shingles occurs after vaccination, the vaccine can help reduce its severity and the risk of long-term nerve pain called postherpetic neuralgia.
Maintaining good blood sugar control is important for overall health and can help support immune function in people with diabetes. Keeping blood glucose levels within the target range reduces the risk of infections and other complications, and can help the immune system function more effectively.
If shingles symptoms appear, prompt medical attention is important because antiviral medications are most effective when started early. Antiviral drugs such as acyclovir, famciclovir, and valacyclovir can reduce the duration and severity of the rash and lower the risk of complications like postherpetic neuralgia. These medications should ideally be initiated within 72 hours of the rash’s first appearance for maximal benefit.