DM severity is strongly associated with the risk of active TB in people with T2DM [TB0094]

·  Focus on TB Screening in Diabetics: Targeting individuals with diabetes (DM) and a high diabetes severity score for TB screening may be feasible and beneficial in clinical practice, especially in resource-limited settings.

·  Parameters to Define Diabetes Severity:

  • Use of insulin and/or multiple oral hypoglycemic agents (OHAs)
  • Duration of diabetes ≥ 5 years
  • Presence of cardiovascular disease (CVD)
  • Presence of chronic kidney disease (CKD)
  • These parameters are easily obtainable in clinical practice and do not require laboratory testing.

·  Association Between Diabetes Severity and TB Risk: A significant association exists between the number of diabetes severity parameters and the increased risk of tuberculosis (TB). Those with more severe diabetes are at higher risk of developing TB.

·  FBG Concentration and TB Risk:

  • The fasting blood glucose (FBG) level is crucial for managing diabetes and ensuring good glycemic control.
  • A J-shaped association between FBG concentration and TB risk was observed, with the lowest TB risk found in FBG levels around 130 mg/dL.
  • FBG levels ≤100 mg/dL were associated with a 37% higher risk of active TB.

·  Potential Reasons for Low FBG and TB Risk:

  • Low FBG might indicate poor nutritional status, liver dysfunction, or other undiagnosed illnesses, which may increase the risk of TB.
  • Both hyperglycemia and hypoglycemia are linked to a higher risk of developing TB.

·  Targeted TB Screening: People with a higher diabetes severity score, particularly insulin users or patients with CKD, could be prioritized for additional TB screening in clinical settings.

Source: Kang, J.Y., Han, K., Lee, S.H. and Kim, M.K., 2023. Diabetes severity is strongly associated with the risk of active tuberculosis in people with type 2 diabetes: a nationwide cohort study with a 6-year follow-up. Respiratory Research, 24(1), pp.1-9.




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