The role of diabetes mellitus in the higher prevalence of tuberculosis among Hispanics.

Abstract

Diabetes mellitus remains a significant risk factor for tuberculosis in the United States. The association is especially notable in middle-aged Hispanics.

Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed tuberculosis cases

“…2,3 Prior to the 1950s reports of an association between diabetes (primarily type 1) and TB were frequent in the literature, but they waned as insulin and drugs against TB became available. 4,5 This association (now with type 2 diabetes) was recognized again in the 1990s [6][7][8][9] and is currently supported by a growing body of literature. [6][7][8][9][10][11][12][13][14][15][16][17] According to a recent meta-analysis, diabetes patients have three times the risk of contracting TB as non-diabetics (95% confidence interval, CI: 2.3-4.3) 18 and studies report the fraction of TB cases attributable to diabetes to be between 15% and 25%.…”

“…[6][7][8][9][10][11][12][13][14][15][16][17] According to a recent meta-analysis, diabetes patients have three times the risk of contracting TB as non-diabetics (95% confidence interval, CI: 2.3-4.3) 18 and studies report the fraction of TB cases attributable to diabetes to be between 15% and 25%. 9,13,16 The biological basis for the association between both diseases is not fully understood but studies suggest that diabetes depresses the immune response, which in turn facilitates infection with Mycobacterium tuberculosis and/or progression to symptomatic disease. This is corroborated by the fact that diabetes is generally diagnosed before TB develops.…”

Tuberculosis Knowledge, Perceived Risk and Risk Behaviors Among Homeless Adults: Effect of Ethnicity and Injection Drug Use

“…18,19 If TB is not perceived to be a serious health risk, whether due to language barriers or other reasons, the likelihood of reducing the prevalence of TB in homeless populations will not be diminished. The prevalence of latent TB is higher among African Americans, Latinos, Asians/Pacific Islanders, and American Indians/Alaskan Natives compared to Whites, [20][21][22] with rates consistently highest among African Americans and Latinos. 8,21,23,24 Prevalence is amplified for minority homeless populations.…”

‘The tubercular diabetic': the impact of diabetes mellitus on tuberculosis and its threat to global tuberculosis control

“…10 A case-control study in California involving 5,290 hospital discharges who had a diagnosis of TB found that the risk of TB attributable to DM among middle-aged Hispanics (25.2%) was similar to that attributable to HIV infection (25.5%), whereas among the middle-aged White population the risk of TB attributable to DM (2.4%) was far lower than the risk attributable to HIV (45.7%). 11 …”