Diabetes mellitus and latent tuberculosis infection

The incidence of diabetes mellitus is positively associated with latent tuberculosis infection. Cross-sectional studies indicate an increased odds of association. Diagnostic methods for LTBI, including TST and IGRA, show comparable results. Individuals from areas with a higher TB burden have a greater likelihood of association compared to those from areas with a lower TB burden.[1]

Individuals who do not initially clear Mycobacterium tuberculosis may develop latent tuberculosis infection (LTBI). Treatment for LTBI aims to prevent progression to active tuberculosis and is particularly recommended for high-risk groups in low TB-burden countries. These groups include people living with HIV, close contacts of pulmonary TB cases, patients undergoing anti-tumor necrosis factor treatments, dialysis patients, those awaiting organ or hematological transplants, and individuals with silicosis. The goal is to mitigate the risk of reactivation in these vulnerable populations.[2]

Research on the association between diabetes mellitus (DM) and LTBI presents mixed findings. A cohort study suggested a non-significant increase in LTBI risk among diabetics, while cross-sectional studies found a modest association, with a pooled odds ratio indicating limited benefit in targeting diabetics for LTBI screening. Socioeconomic factors, such as lower income and increased TB exposure through social networks, may amplify TB risk in individuals with diabetes, highlighting the complex interplay of shared risk factors between the two conditions.[2]

References:

[1] Zhou, G., Guo, X., Cai, S., Zhang, Y., Zhou, Y., Long, R., Zhou, Y., Li, H., Chen, N. and Song, C., 2023. Diabetes mellitus and latent tuberculosis infection: an updated meta-analysis and systematic review. BMC Infectious Diseases, 23(1), p.770.

[2] 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.