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Diabetes and Shingles

Shingles is a painful skin rash caused by the virus that causes varicella, or chickenpox. Learn how diabetes and shingles are related and what you can do to lower your risk for getting it, or how you can prevent it entirely.

Nearly one in three Americans will develop shingles in their lifetime, according to the Centers for Disease Control and Prevention. And, for those who have diabetes, the risk for developing this painful skin condition is even higher. Fortunately, there are ways to reduce your risk or even prevent this agonizing condition.

What is shingles?

Shingles is a painful, blistering skin rash that is caused by the varicella-zoster virus (VZV). This virus is the same one responsible for chickenpox. While the rash can occur anywhere on the body, it most commonly follows a nerve path. The affected areas are typically on your chest, abdomen, and back, but nerves on your head and face can sometimes be affected. If the nerves around the eyes or ears are affected, serious complications can occur, so seek expert advice urgently.

People who have had chickenpox are at risk of developing shingles later in life. "The virus typically lies dormant along nerve tissues near your brain and spinal cord, which is why the rash often follows a nerve and is limited to only one side of the body," says Dr. Yasmin Akhunji, an endocrinologist with Paloma Health.

According to the CDC, a person with shingles can spread VZV to those who have not had chickenpox or received its vaccine, leading to chickenpox in those people, and potentially shingles down the road. People who have shingles should cover the rash and wash their hands regularly to reduce the risk of spreading the virus.

What are the symptoms of shingles?

The first symptom of shingles is typically a burning or tingling pain on one side of the body. This may precede the development of a rash by several days or even weeks. The rash itself consists of small, fluid-filled blisters that eventually turn into scabs. It can be quite itchy and may be accompanied by fever, headache, and body aches.

"Compared to other viral infections, shingles is not life-threatening, but is extremely painful," says Akhunji. Some people may experience long-term nerve pain, called postherpetic neuralgia. This is one of the most common complications of shingles and can cause ongoing pain long after the rash goes away.

Can diabetes increase your risk for shingles?

Several studies have shown that people living with diabetes are at an increased risk of developing shingles. A 2018 review published in Diabetes Therapy found that those with diabetes are more likely to experience postherpetic neuralgia, long-lasting and intense pain after having shingles.

"People with either type of diabetes may already have nerve pain, or neuropathy, so having shingles may exacerbate this symptom and cause it to linger longer than in non-diabetic individuals," says Akhunji. Another theory is that people with diabetes may have weakened immune systems, making them more susceptible to VZV.

A 2020 review published in Science Direct also found a correlation between diabetes and shingles. Although the CDC recommends that all people over 50 get the shingles vaccine, this study led to the recommendation that shingles vaccines should specifically be included in diabetes care plans.

Shingles treatment

"Many people with diabetes find their blood sugar is more difficult to control for up to six months after their shingles infection,” said Akhunji. “They are also more likely to be hospitalized for other health complications in the months following a shingles infection."

For these reasons, it's important to be aware of the symptoms of shingles and see a healthcare professional right away if you suspect you have it.

According to the CDC, there is no cure for shingles. However, there are ways to help relieve symptoms and shorten the duration of the illness.

Treatment may include:

  • Antiviral medications: To shorten the duration and severity of the virus

  • Pain medications: To help relieve pain

  • Bandages: To keep the rash clean and minimize the risk of spread

  • Home remedies: Cool compresses and calamine lotion can reduce discomfort

Bates was lucky that his shingles episode cleared quickly after starting treatment, however, "It did spark up a couple of weeks ago," he adds. "That episode was right before an eye exam. I did have a little pain behind my right eye.”

Tips to prevent shingles

If you're living with diabetes, it's essential to understand your increased risk and take steps to prevent the virus by getting vaccinated. "The shingles vaccine is the only approved method for preventing shingles from developing, or at least limiting its severity," Dr. Akhunji says.

Shingrex, an FDA-approved shingles vaccine for people over 50 and adults over 18 at increased risk of shingles, is available as a two-dose series. You should receive the second dose two to six months after the initial dose.

Your healthcare provider or local pharmacy can provide more information on whether the shingles vaccine is right for you. Talk with your provider about any side effects associated with the shingles vaccine and whether you may have allergies. 

In addition to the Shingles vaccine, there are other ways to help prevent shingles:

  • Strengthen your immune system by eating a healthy diet, exercising, getting enough sleep, and keeping your glucose in range

  • Wash your hands regularly.

  • Avoid contact with people who have chickenpox or shingles.

  • If you experience symptoms you think may be shingles, see a healthcare provider. (Your healthcare provider will be able to accurately diagnose shingles and provide the best possible treatment.)

While it's important to be aware of your increased risk for shingles if you have diabetes, it's also important not to panic.  Follow your provider's recommendations for preventing shingles, and remember that the vaccine is your best bet.