The risk of tuberculosis disease among persons with DM

In Spain, a total of 8,004 diabetes patients were analyzed over 68,605 person-years of follow-up (PYFU), with 48 developing TB. Compared to those without TB, DM patients with TB were younger (52.2 vs. 57.7 years), had higher triglycerides (122 vs. 105 mg/dl), a higher prevalence of diabetic nephropathy and neuropathy, and were more frequently from Hindustan (29.2% vs. 13.4%). Baseline HbA1c values were available for 46 DM patients with TB. No significant differences were found between HbA1c ≥ 7.5% and < 7.5% groups in TB localization, radiography, or tuberculin skin test results. At TB diagnosis, 88.8% were symptomatic, and 44% were smear-positive (21.3% smear-negative but culture-positive). Drug-resistant TB was found in 13.5% of cases. The TB incidence rate was 70 per 100,000 PYFU in the overall DM group and 90 per 100,000 among those with available HbA1c. TB incidence increased with HbA1c levels, highest in those with HbA1c ≥ 9%, followed by ≥ 8% and ≥ 7.5%.[1] See also: https://tbreadingnotes.blogspot.com/2024/09/exploring-diagnostic-methods-for-drug.html

Incidence curves showed that patients with HbA1c ≥ 9% had the highest TB risk. The association between HbA1c and TB risk was analyzed for different HbA1c cut-offs (≥ 7.5%, 8%, and 9%). Higher HbA1c levels correlated with increased TB incidence, peaking at HbA1c ≥ 9%. After adjusting for age and sex (Model 1), statistical significance was found for HbA1c ≥ 8% and ≥ 9%. However, when adjusting for additional factors (Model 2), including DM duration, macrovascular complications, alcohol or smoking habits, BMI, and geographical origin, the significance was lost. Overall, TB risk increased with higher HbA1c levels.[1] See also: https://tbreadingnotes.blogspot.com/2024/08/clinical-tuberculosis.html

Diabetes mellitus (DM) increases the risk of developing tuberculosis (TB) disease, sharing several risk factors with TB, such as older age, unemployment, and low educational status. Patients with more severe DM are particularly vulnerable to TB, although the exact mechanisms by which DM increases susceptibility to TB and other infectious diseases remain unclear. As DM prevalence is expected to rise in many regions with high and moderate TB burdens, effective TB elimination strategies must include a focus on managing and addressing DM to reduce the risk and impact of TB in these populations.[2] See also: https://tbreadingnotes.blogspot.com/2024/09/tuberculosis-mortality-in-brunei.html

References:

1. Antonio-Arques, V., Caylà, J.A., Real, J., Moreno-Martinez, A., Orcau, À., Mauricio, D., Mata-Cases, M., Julve, J., Navas Mendez, E., Puig Treserra, R. and Millet, J.P., 2022. Glycemic control and the risk of tuberculosis in patients with diabetes: A cohort study in a Mediterranean city. Frontiers in public health, 10, p.1017024.

2. Baker, M.A., Lin, H.H., Chang, H.Y. and Murray, M.B., 2012. The risk of tuberculosis disease among persons with diabetes mellitus: a prospective cohort study. Clinical Infectious Diseases, 54(6), pp.818-825.