coronary artery disease; sleep apnea; Obesity; Hypercholesteremia; Vitamin B 12 deficiency; Carpal tunnel syndrome; restrictive lung disease; HO proteinuria syndrome; shortness of breath; Lumbar strain; Pre-syncope; Osteoarthritis; Hyperlipidemia; Diabetes mellitus; Hypertension; Cough; This case was reported by a physician via patient support programs and described the occurrence of diabetes mellitus in a 54-year-old male patient who received Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2017-2018 season) for prophylaxis.   The patient's past medical history included proteinuria, coronary artery disease, hypercholesterolemia, bypass surgery, coronary stent placement, sleeve gastrectomy, alzheimer's disease (Family History) (patient's mother history), arthritis (Family History) (patient's mother history) and heart attack (Family History) (patient's father history). Previously administered products included Influenza (received in 3rd October 2016, refer case US2020AMR176925). Concurrent medical conditions included smoker. Concomitant products included glyceryl trinitrate (Nitroglycerin),  (Sublingual), cyanocobalamin (Vitamin B12 Injection), insulin lispro (Humalog U 100), insulin nos (Insulin), omeprazole, ergocalciferol (Vitamin D2), isosorbide mononitrate (Isosorbide Mononitrate Er), metoprolol tartrate, temazepam, lovastatin, paracetamol (Tylenol), lisinopril, cyanocobalamin, dapagliflozin propanediol + metformin hydrochloride (Xigduo), sitagliptin (Januvia), umeclidinium bromide + vilanterol trifenatate (Anoro Ellipta) and insulin glargine (Lantus).   On 1st November 2017, the patient received Influenza vaccine Quadrivalent 2017-2018 season. On 11th January 2017, less than a day after receiving Influenza vaccine Quadrivalent 2017-2018 season, the patient experienced diabetes mellitus (serious criteria GSK medically significant), cough and hypertension. On 30th August 2017, the patient experienced hyperlipidemia. On 28th February 2018, the patient experienced presyncope and osteoarthritis. On 12th September 2018, the patient experienced lumbar strain. On an unknown date, the patient experienced coronary artery disease, sleep apnea, obesity, hypercholesterolemia, vitamin b12 deficiency, carpal tunnel syndrome, restrictive pulmonary disease, proteinuria and shortness of breath. On an unknown date, the outcome of the diabetes mellitus, coronary artery disease, sleep apnea, obesity, hypercholesterolemia, vitamin b12 deficiency, carpal tunnel syndrome, cough, presyncope, osteoarthritis, restrictive pulmonary disease, hypertension, hyperlipidemia, proteinuria, lumbar strain and shortness of breath were unknown.   It was unknown if the reporter considered the diabetes mellitus, coronary artery disease, sleep apnea, obesity, hypercholesterolemia, vitamin b12 deficiency, carpal tunnel syndrome, cough, presyncope, osteoarthritis, restrictive pulmonary disease, hypertension, hyperlipidemia, proteinuria, lumbar strain and shortness of breath to be related to Influenza vaccine Quadrivalent 2017-2018 season.  Additional details were reported as follows: The received Influenza vaccine and has coronary artery disease, restrictive lung disease, shortness of breath and sleep apnea. It also reports that he has had a knee replacement.  The patient's history and Illness included follow up restrictive lung disease obesity, persists,coronary artery disease. He has no chest pain or precordial discomfort. Obstructive lung disease. He received anoro, Shortness of breath, stable.S P knee replacement, remote sleep apnea, stable.Nitroglycerin 0.4 mg sublingual tablet 1 STAT PRN for 90 days, Prescribe 25 Tablet, Refills 4. BD Integra Syringe 3 mL 25 gauge x 5 by 8 inch Use biweekly as directed for vitamin b12 injections, Prescribe 100 Syringe, Refills 4. Humalog U 100 Insulin 100 unit per mL subcutaneous solution 30 Unit Three Times A Day for 30 Days , Prescribe 2700 Unspecified, Refills 5. Omeprazole 40 mg capsule,delayed release take one capsule by mouth daily for 90 Days , Prescribe 90 Capsule, Refills 1. Vitamin D2 50,000 unit capsule 1 Capsule Onoe a month for 60 days, Refills 2 Isosorbide mononitrate ER 30 mg tablet,extended release 24 hour 1 Tablet Every Morning for 90 Days , Prescribe 90 Tablet, Refills 2 Metoprolol tartrate 25 mg tablet 1 tablet twice a day for 90 days, Prescribe 180 Tablet, Refills 2 Temazepam 30 mg capsule 1 Capsule Once A Day, Prescribe 1 Capsule Lovastatin 20 mg tablet 1 tablet at Bedtime for 90 days, Prescribe 90 Tablet, Refills 2 Tylenol-Codeine #3 300 mg-30 mg tablet 1 Every Morning, Prescribe 1 Unspecified lisinopril 2.5 mg tablet 1 Tablet Every Morning for 90 days, Prescribe 90 Tablet, Refills 4 cyanocobalamln (vit B-12) 1,000 mqg/mL injection solution 1 Milligram every 2 weeks for 90 Days Prescribe 90 Milligram, Refills 12 Xigduo XR 5 mg-1,000 mg tablet,extended release 1 Tablet Twice A Day DX E11.8 for 30 Days , Prescribe 60 tablet, refills 3 onetouch ultra blue test strip 1 strip six times daily for 90 days, prescribe 540 strip, refills 3 Januvia 100 mg tablet 1 tablet once a day for 30 days, prescribe 30 tablet, refills 1 anoro ellipta Lantus U-100 Insulin 100 unlt per mL subcutaneous solution 80 Unit At Bedtime for 12 days, Prescribe 2 Vial No known drug allergies. For Influenza vaccine Quadrivalent 2016-2017 season refer case US2020AMR176925.; Sender's Comments:  US-GLAXOSMITHKLINE-US2020AMR176911:Influenza 2017-2018 US-GLAXOSMITHKLINE-US2020AMR176925:same patient