Diabetes Mellitus Raises Active Tuberculosis Risk Nearly 2.5-Fold, Suggests Study
A recent case-control study published in the Indian Journal of Community Medicine in July 2024 confirms that diabetes mellitus independently raises the risk of active tuberculosis by nearly 2.5-fold (adjusted odds ratio = 2.456, 95% CI: 1.310–4.606, P = 0.005). This key finding demonstrates that impaired glycemic control significantly heightens susceptibility to mycobacterial infection.
While tuberculosis and diabetes mellitus pose major global health burdens, prior systematic reviews left a clinical gap regarding localized community-level risk quantification; addressing this, Dr. Prashant R. Kokiwar and Dr. Arun K. Soodi Reddy from Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India, evaluated whether DM is significantly associated with active TB.
Therefore, the community-based case-control study in Medchal District, India, evaluated 215 newly diagnosed pulmonary tuberculosis patients alongside 215 matched controls to examine the link between diabetes and tuberculosis. After excluding individuals with prior tuberculosis exposure or chronic lung diseases, researchers measured fasting blood glucose and applied multivariable logistic regression to determine disease risk.
Key Clinical Findings of the Study Includes:
- Elevated Diabetes Risk: Researchers observed that known DM significantly increased TB odds compared to non-diabetic controls (OR = 2.456, 95% CI: 1.310–4.606, P = 0.005; 67% vs. 33% controls).
- Impact of Family History: Investigators demonstrated that family history of TB strongly predicted active infection (OR = 18.372, 95% CI: 4.053–83.280, P < 0.001; 95.3% vs. 4.7% controls).
- Influence of Tobacco Chewing: Authors reported that tobacco chewing significantly heightened TB susceptibility (OR = 2.980, 95% CI: 1.218–7.292, P = 0.017; 85.7% vs. 14.3% controls).
- Protective Effect of Body Mass Index: Scientists found that higher body mass index (BMI) protected against TB (OR = 0.838 per kg/m², 95% CI: 0.794–0.884, P < 0.001; cases vs. controls: 20.82 ± 5.01 vs. 25.63 ± 4.84 kg/m²).
- Elevated Glycemic Profile: Analysts noted that mean FBG levels were significantly higher in TB cases than controls (120.07 ± 55.19 vs. 109.48 ± 41.97 mg/dL, P = 0.026).
The results suggest that diabetes mellitus serves as a statistically significant independent risk factor for tuberculosis (OR = 2.456, P = 0.005) after adjusting for age, BMI, blood pressure, tobacco chewing, and family history.
Thus, the study concludes that primary care clinicians should consider implementing routine tuberculosis symptom screening among diabetic patients and integrating active case-finding protocols into community non-communicable disease programs.
Although constrained by a single-district sample size, self-reported socio-demographic data, and unassessed human immunodeficiency virus status, future multi-center studies considering viral co-infections could further optimize integrated screening strategies.
Reference
Kokiwar PR, Soodi Reddy AK. Diabetes mellitus as a risk factor for tuberculosis: A community based case control study. Indian J Community Med 2024;49:617-21.
