Risk factors for diabetes among tuberculosis patients

A study in two financially affluent Chinese cities, Shenzhen and Kunming, investigated the prevalence of diabetes mellitus (DM) among pulmonary tuberculosis (PTB) patients. A total of 410 hospitalized patients suspected of TB were initially screened, with 322 confirmed PTB cases included in the final analysis. Among them, 16.8% (54 patients) had both PTB and DM, while 83.2% (268 patients) had PTB alone. Patients in the PTB-DM group were significantly older (55.44 ± 12.36 years vs. 46.09 ± 16.87 years, P < 0.001) and predominantly male (79.6% vs. 59.7%, P < 0.001). Lifestyle factors such as higher alcohol consumption and lower education levels were more common in the PTB-DM group (P < 0.05), while no significant differences were found in marital status, TB symptoms, or vaccination history. Nutritional and metabolic differences were also notable, with the PTB-DM group showing higher body weight, waist circumference, and elevated blood glucose levels, as well as a higher likelihood of having a family history of diabetes (P < 0.05).[1] See also: https://lintblab.weebly.com/

Risk factors for diabetes among PTB patients included male gender (3.29 times higher risk), older age (1.04 times higher risk per year increase), family history of diabetes (5.09 times higher risk), and elevated random blood glucose levels (1.6 times higher risk per unit increase). Heavy alcohol consumption further increased diabetes risk, whereas minimal alcohol intake appeared to be protective. Diabetes awareness was also found to be a protective factor (adjusted odds ratio = 0.07, 95% CI: 0.03–0.21). These findings highlight the significant burden of diabetes among PTB patients and emphasize the importance of targeted screening and interventions for high-risk groups, particularly older males with high alcohol consumption and a family history of diabetes.[1]

The rising prevalence of diabetes mellitus (DM) poses a growing threat to tuberculosis (TB) control efforts, as DM increases the risk of active TB and worsens treatment outcomes. This dual burden is especially concerning in low- and middle-income regions, where TB is already widespread, making DM a risk factor comparable to HIV/AIDS. Despite its impact, resources for TB-DM research and treatment remain scarce, and large-scale clinical trials are lacking, leaving significant gaps in managing this comorbidity.[2]

A nationwide cohort study in South Korea (2011–2018) examined the impact of diabetes mellitus (DM) on tuberculosis (TB) outcomes using national health data. TB patients with DM were more likely to be older, male, and from lower-income groups, with more severe disease profiles and higher comorbidity burdens. They experienced worse treatment outcomes, including higher mortality rates and shorter survival times, with TB being the leading cause of death (47.9%). DM significantly increased the risk of TB-related mortality in men and non-TB-related deaths in both sexes. Factors like advanced age, low income, and higher comorbidity scores contributed to poorer outcomes, highlighting the need for targeted interventions in this high-risk group.[3]

References:

1. Li, J., Zhao, Y., Jiang, Y., Zhang, Y., Zhang, P., Shen, L. and Chen, Z., 2024. Prevalence and risk factors of diabetes in patients with active pulmonary tuberculosis: a cross-sectional study in two financially affluent China cities. Diabetes, Metabolic Syndrome and Obesity, pp.1105-1114.

2. Bao, J., Hafner, R., Lin, Y., Lin, H.H. and Magee, M.J., 2018. Curbing the tuberculosis and diabetes co-epidemic: strategies for the integration of clinical care and research. The International Journal of Tuberculosis and Lung Disease, 22(10), pp.1111-1112.

3. Kwak SH, Jeong D, Mok J, Jeon D, Kang H-Y, Kim HJ, et al. (2023) Association between diabetes mellitus and cause of death in patients with tuberculosis: A Korean nationwide cohort study. PLoS ONE 18(12): e0295556. https://doi.org/10.1371/journal.pone.0295556