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Undiagnosed diabetes mellitus and tuberculosis infection: A population‐based, observational study from eastern China
Author(s) -
Liu Qiao,
Lu Peng,
Martinez Leonardo,
Peng Hong,
Zhu Tao,
Zhu Limei,
Wang Jianming,
Lu Wei
Publication year - 2020
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3227
Subject(s) - medicine , tuberculosis , quantiferon , tuberculin , diabetes mellitus , population , incidence (geometry) , odds ratio , cohort study , confidence interval , observational study , latent tuberculosis , mycobacterium tuberculosis , environmental health , pathology , endocrinology , physics , optics
Background China has the largest dual diabetes and tuberculosis epidemic globally. No studies from mainland China have assessed the relationship between tuberculosis infection and diabetes. We conducted a population‐based, observational study in eastern China to further explore this relationship. Methods A blood glucose, Quantiferon, and tuberculin skin test were administered at baseline. We compared tuberculosis infection in nondiabetics and diabetics. The cohort was additionally screened for tuberculosis progression over 5 years. Results Among 5405 participants, diabetics had elevated levels of Quantiferon and tuberculin positivity, largely driven by undiagnosed diabetics (compared with nondiabetics, adjusted odds ratios of 1.53; 95% confidence interval [CI], 1.05‐2.23 and 1.58; 95% CI, 1.07‐2.35 for tuberculin and Quantiferon positivity). During follow‐up, the annual tuberculosis incidence was three times higher for diabetics compared with the entire cohort. Conclusions These results suggest improving diabetic control through rapidly identifying undiagnosed diabetes may have indirect benefits to tuberculosis control. Targeting of preventive therapy to newly diagnosed diabetics at high‐risk for progressive tuberculosis in China should be considered.