HO proteinuria syndrome; sleep apnea; Carpal tunnel syndrome; coronary artery disease; Hypercholesteremia; wheezing is minimal; morbid obesity/obesity; Restrictive lung disease; Obstructive lung disease; shortness of breath; Night sweats; Type 2 diabetes mellitus/diabetes mellitus; Type 2 diabetes mellitus with diabetic neuropathy; Insomnia; Knee pain; This case was reported by a physician via patient support programs and described the occurrence of type ii diabetes mellitus in a 55-year-old patient who received Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2018-2019 season) for prophylaxis.   The patient's past medical history included knee replacement, type ii diabetes mellitus (uncontrolled, without complications), hyperlipidemia, anemia, vitamin d low, leg pain, sleeve gastrectomy, gastric bypass, cough, diarrhea, polycythemia, osteoarthritis, chest discomfort, presyncope, lumbar strain, smoker (every day), coronary stent placement and gastric stapling. Previously administered products included Influenza vaccine with an associated reaction of anaemia (received dose on 03rd October 2016 and experienced anemia. For the tolerance of dose, refer linked case US2020AMR176925) and Influenza vaccine with an associated reaction of hypertension (received dose on 01st November 2017 and experienced hypetension. For the tolerance of dose, refer linked case US2020AMR176926). Concurrent medical conditions included hypertension, heart attack (Family History), alzheimer's disease (Family History) and arthritis (Family History). Concomitant products included nitroglycerine, omeprazole, ergocalciferol (Vitamin D2), isosorbide mononitrate, cyanocobalamin (Vitamin B12 Injection), metoprolol tartrate, temazepam, insulin lispro (Humalog), lovastatin, lisinopril, dapagliflozin propanediol + metformin hydrochloride (Xigduo Xr), sitagliptin (Januvia) and insulin glargine (Lantus).   On 17th October 2018, the patient received Influenza vaccine Quadrivalent 2018-2019 season. On 17th October 2018, less than 2 years after receiving Influenza vaccine Quadrivalent 2018-2019 season and an unknown time after starting nitroglycerine, omeprazole and Vitamin D2, the patient experienced insomnia and knee pain. On 8th March 2019, the patient experienced type ii diabetes mellitus (serious criteria GSK medically significant) and diabetic neuropathy. On 29th March 2019, the patient experienced night sweat. On 17th February 2020, the patient experienced restrictive pulmonary disease, lung disease obstructive and shortness of breath. On 27th April 2020, the patient experienced morbid obesity. On an unknown date, the patient experienced proteinuria, sleep apnea, carpal tunnel syndrome, coronary artery disease, hypercholesterolemia and wheezing. On an unknown date, the outcome of the type ii diabetes mellitus, diabetic neuropathy, morbid obesity, proteinuria, sleep apnea, carpal tunnel syndrome, coronary artery disease, hypercholesterolemia, insomnia, knee pain, night sweat, restrictive pulmonary disease, lung disease obstructive, shortness of breath and wheezing were unknown.   It was unknown if the reporter considered the type ii diabetes mellitus, diabetic neuropathy, morbid obesity, proteinuria, carpal tunnel syndrome, coronary artery disease, hypercholesterolemia, insomnia, knee pain, night sweat, restrictive pulmonary disease, lung disease obstructive, shortness of breath and wheezing to be related to Influenza vaccine Quadrivalent 2018-2019 season. The reporter considered the sleep apnea to be probably related to Influenza vaccine Quadrivalent 2018-2019 season.  Additional details were provided as follows: The patient did not have known drug allergies. The patient was a large man in no stress. The neck shown no lymph node swelling. His lungs shown diminished breath sounds without wheezing. The patient's heart rhythm was regular with no headache or dizziness, no neck pain and no abdominal pain. The also received Anoro and would continue Anoro. After receiving Influenza vaccine, the patient experianced type ii diabetes mellitus, diabetic neuropathy, morbid obesity, proteinuria, sleep apnea, carpal tunnel syndrome, coronary artery disease, hypercholesterolemia, insomnia, knee pain, night sweat, gastric stapling, restrictive pulmonary disease, lung disease obstructive, shortness of breath and wheezing. This was 1 of 4 linked cases received for the same patient.; Sender's Comments:  US-GLAXOSMITHKLINE-US2020AMR176926:Influenza 2017-2018 US-GLAXOSMITHKLINE-US2020AMR176925:Influenza 2016-2017 US-GLAXOSMITHKLINE-US2020AMR176890:Pharma case (Anoro)