A new paper published in the open-access journal PLoS Medicine finds that people with diabetes mellitus are at increased risk of developing active tuberculosis (TB). Diabetes mellitus is characterized by abnormally high blood sugar level due to insufficient amounts of the insulin hormone, and TB is an infectious disease that usually attacks the lungs.

This conclusion comes from a meta-analysis conducted by Christie Jeon and Megan Murray of the Harvard School of Public Health. The researchers identified 13 studies from the last 40 years that contained enough data to assess the relationship between diabetes and TB. These studies consisted of over 1.7 million participants who had 17,698 cases of TB. The aggregated data revealed a three-fold increase in risk of active TB for patients with diabetes.

According to the authors, a risk increase of this magnitude could mean that diabetes is a factor driving over 10% of TB cases in India and China. Replication of these findings in other countries would provide public health professionals with a reason to place some focus on diabetes sufferer when identifying and treating latent (asymptomatic) TB. TB kills about 1.6 million people every year, a number that may decrease if diagnosis and treatment of diabetes can interrupt TB as well.

“Our findings suggest that TB controls programs should consider targeting patients with diabetes for interventions such as active case finding and the treatment of latent TB and, conversely, that efforts to diagnose, detect, and treat DM [diabetes mellitus[ may have a beneficial impact on TB control. We also recommend further studies investigating how TB risk varies by type, duration, and severity of DM, for a more thorough understanding of the association that could be translated to a clear public health message,” conclude the authors.

Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies
Jeon CY, Murray MB.
PLoS Medicine (2008). 5(7): e152.
Click Here to View Perspective Article

About PLoS Medicine

PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world’s scientific and medical literature a freely available public resource. For more information, visit http://www.plos.org

Written by: Peter M Crosta