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Patients with diabetes at high risk for developing tuberculosis
Restrepo BI. Bull World Health Organ. 2011;89:352-359.
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The risk for contracting tuberculosis is three to five times higher for patients with diabetes compared with those without the diabetes, according to researchers at the University of Texas Health Science Center at Houston.
“With diabetes on the rise in [tuberculosis]-endemic areas, our findings highlight the re-emerging impact of diabetes … on [tuberculosis] control in regions of the world where both diseases are prevalent,” the researchers wrote in their study.
Blanca Restrepo, PhD, associate professor of epidemiology at University of Texas School of Public Health, Brownsville Regional Campus, and colleagues enrolled 233 patients with probable tuberculosis (TB) between March 2006 and September 2008 at TB clinics in South Texas and northeastern Mexico. The purpose of the study was to estimate the risk for TB attributable to diabetes in those living along the Mexican border. They used primary data from patients with newly diagnosed TB who were tested for diabetes, according to the study.
The prevalence of diabetes was higher among patients with TB vs. the general population in South Texas (39.3% vs. 19.5%) and northeastern Mexico (36% vs. 15.1%). The researchers estimated that patients with diabetes had three times the risk for developing TB compared with those without diabetes, and that risk was five times higher for those aged 35 to 64 years. In patients aged at least 20 years, the estimated fraction of TB cases attributable to diabetes was 26% in South Texas and 24% in northeastern Mexico. The rate increased to 48% among people aged between 35 and 64 years living in South Texas. Across the population, the fraction of TB cases attributable to diabetes was 63% in South Texas and 68% in northeastern Mexico.
According to the researchers, almost all of the patients with diabetes were aware of their diabetes disease status at least 6 months before TB diagnosis.
“These findings reveal that diabetic patients with TB are not new to the health care system and highlight the fact that opportunities for preventing TB among diabetes patients are often missed,” the researchers wrote. “While not all diabetes patients with latent TB infection should take prophylactic treatment, such patients should be made aware of their risk of TB and should discuss with their physicians the potential risks and benefits of taking preventive anti-TB treatment.”
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