Shingles and diabetes in over 50: What you need to know

Shingles and diabetes are two distinct health conditions, but people with diabetes — especially those over 50 — are more likely to get shingles.¹

Diabetes is a chronic condition that affects how the body regulates blood sugar levels.² Over time, diabetes can not only weaken the immune system but also lead to serious health complications, including nerve damage, vision loss, kidney failure, and an increased risk of heart disease and stroke.^2,3

Shingles, also known as herpes zoster, is a painful viral infection.^4,5 It causes a localized, blistering rash that typically appears on one side of the body and can sometimes affect the face and the area around an eye.^4,5 The infection is caused by the reactivation of the varicella-zoster virus (VZV), the same virus responsible for chickenpox.^4,5 After a person recovers from chickenpox, the virus remains dormant in the nerve tissue and may reactivate later in life, causing shingles.^4,5

Why are people over 50 with diabetes at a higher risk for shingles?

Anyone who has had chickenpox can develop shingles.³ Additionally, research shows that individuals with diabetes have about a 26%^a higher likelihood of developing shingles.¹ Moreover, people with diabetes are not only more likely to get shingles but may also experience more severe symptoms and complications, including increased hospitalisation.⁶

The main reason for this increased risk appears to be that diabetes can weaken the body’s immune system.² The presence of other diabetes-related complications can further reduce immune function, making infections harder to control.² When the immune system is compromised, it becomes harder for the body to keep the chickenpox virus dormant.^4,5 This increases the chance that the virus will reactivate and cause shingles. ^4,5

Age is another major risk factor for developing shingles.^4,5 After the age of 60, the immune system naturally weakens.⁷ The presence of other chronic conditions (such as diabetes, asthma, chronic obstructive pulmonary disease, and cardiovascular disease) further compromises the immune system and increases the risk of shingles in older adults.¹

Shingles and diabetes: Potential complications and long-term effects

Increased risk of stroke and heart attack

A shingles infection puts extra strain on the heart and blood vessels.⁸ For someone with diabetes, this can raise the risk of having severe complications — such as stroke or heart attack by about 25%^b in the month after shingles appear.⁹

Secondary bacterial infections

Having both shingles and diabetes can further weaken the immune system, making individuals more susceptible to secondary infections. These can include bacterial infections of the skin at the site of the shingles rash, as well as respiratory or urinary tract infections.^4,10

Long-term nerve pain

People with diabetes are more likely to develop postherpetic neuralgia (PHN), a chronic nerve pain condition.¹¹ This nerve pain can persist long after the rash has healed and may continue for many years.⁴

Slower wound healing

People with diabetes take longer to recover from illnesses, cuts and wounds.¹⁰ Bacterial infection can also complicate a shingles rash.⁵

Uses more healthcare resources

Diabetes has also been associated with cause severe shingles symptoms and complications.^6,9 As a result, people with diabetes often require more medical care for shingles, including longer hospital stays and higher hospitalisation costs.^6,9,12

Prevention is key

People with diabetes, especially older adults, are more likely to experience severe symptoms and long-term complications if they contract shingles.^1,5 This is why preventing shingles is especially important for people living with diabetes.³

Although there is no cure for shingles, there are numerous preventive options and treatments available.³ If you are over 50 and have diabetes, it is crucial that you consult a healthcare professional to discuss preventive measures.

For someone with diabetes, a shingles infection puts extra strain on the heart and blood vessels, raising their risk of a stroke or heart attack by 25%^b in the month following infection.^8,9

^aData from 17 studies (unadjusted odds ratio: 1.26; 95% confidence interval: 1.03–1.54)
^bN=179 patients with diabetes and shingles