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 Cdc-pdf[PDF – 32 pages]


Healthcare Provider Resources

Resource Page:  Hepatitis B Tools and Resources

Fact Sheet:  Diabetes and Hepatitis B Vaccination – Information for Diabetes Educators Cdc-pdf[PDF – 2 pages]

Patient Resources


Additional Information on diabetes

CDC’s Division of Diabetes Prevention and Control