This article is more than 5 years old. Information may no longer be current.
FDA advisory committee: denosumab benefits outweigh osteoporosis risks
Committee split on denosumab for prevention, treatment of bone loss associated with hormone ablation therapy in patients with breast, prostate cancer.
Click Here to Manage Email Alerts
Researchers reported a high prevalence of tuberculosis in children and adolescents with type 1 diabetes in South Africa and, therefore, recommend routine screening in areas that are highly endemic for the disease.
The cross-sectional, hospital-based study included 258 children and adolescents with type 1 diabetes (58% girls). Each patient underwent a Mantoux tuberculin skin test, chest radiograph and HbA1c measurement.
The overall prevalence of tuberculosis was about 30%; nine participants were diagnosed with prevalent tuberculosis.
Prevalent tuberculosis was associated with poor glycemic control (HR=1.39; 95% CI, 24.2-35.4) and contact with a tuberculosis case.
The prevalence of tuberculosis increased from 7.8% at five years to 12.5% at 10 years after diagnosis of type 1 diabetes. The observed prevalence of tuberculosis among children and adolescents with type 1 diabetes was 6.8 times greater than the prevalence in the general population.
“Preventive treatment should be considered for diabetic children with proof of tuberculosis exposure and/or infection,” the researchers concluded.
Webb EA. Int J Tuberc Lung Dis. 2009;13:868-874.
The association of tuberculosis with HbA1c confirms once again that poor glycemic control leads to impairments in the immune system and an increased incidence for infections.Usually the threshold for this is an HbA1c of 8%.It should be noted that in the group who were not infected the HbA1c was 10.6% compared with 12.4% in the infected group.Hopefully these levels are rarely seen in the U.S. pediatric diabetic population.
– David S. Bell, MD
Endocrine Today Editorial Board member