Diabetes mellitus and latent tuberculosis infection

Lee, M.R., Huang, Y.P., Kuo, Y.T., Luo, C.H., Shih, Y.J., Shu, C.C., Wang, J.Y., Ko, J.C., Yu, C.J. and Lin, H.H., 2017. Diabetes mellitus and latent tuberculosis infection: a systemic review and metaanalysis. Clinical Infectious Diseases, 64(6), pp.719-727.

  • Individuals who do not clear Mycobacterium tuberculosis initially can develop latent tuberculosis infection (LTBI).
  • LTBI treatment is aimed at preventing the progression to active TB, particularly recommended in low TB-burden countries for high-risk groups:
    • People living with HIV
    • Contacts of pulmonary tuberculosis cases
    • Patients beginning anti-tumor necrosis factor treatments
    • Dialysis patients
    • Patients awaiting organ or hematological transplants
    • Patients with silicosis
  • A cohort study indicated a non-significant increased risk of LTBI in diabetics (risk ratio, 4.40; 95% CI, 0.50–38.55).
  • Cross-sectional studies showed a pooled odds ratio of 1.18 (95% CI, 1.06–1.30), suggesting limited benefit from targeting diabetics for LTBI screening.
  • Lower socioeconomic status, a common risk factor for both DM and TB, could increase TB exposure among diabetics due to network dynamics.

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