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. 2020 Feb 24;10:3229. doi: 10.1038/s41598-020-60213-0

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Seasonal vaccination with TIV elicited sero-protection for all groups, but all treated DM groups showed significantly decreased responses against H1N1 and H3N2, in addition to delaying and reducing haemagglutination inhibition (HAI) persistency against influenza B antigen in metformin-DM and glibenclamide-DM. (a) Study design indicating the sample groups and time of blood collection before and after seasonal vaccination with TIV (schematic). Blood samples were collected from Thai individuals with and without T2DM at baseline (day -7) and post-vaccination with TIV (day 0). Antibody responses were evaluated by the HAI assay at baseline, as well as 30, 90, and 270 days post-vaccination against influenza (b) H1N1, (c) H3N2, or (d) B-antigen and compared with non-DM individuals and T2DM patients prescribed metformin (Met; n = 12) or glibenclamide (GB; n = 10), or a combination of the two drugs (Met + GB; n = 18). The dotted line represents the protective threshold HAI titre of 40. (e) HAI antibody titre fold-change (baseline vs. D90) against influenza H1N1, H3N2, or B-antigens compared among all four groups. Comparison of percentage (%)Statistical analyses were undertaken using one-way (b–d) or two-way (e) ANOVA. Horizontal lines represent the geometric mean with 95% CI. *p < 0.05; **p < 0.01; ***p < 0.001; ****p < 0.0001.