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Diabetes and TB Walk the Same Path
Researchers calculated that having diabetes increases the risk of active TB by about a factor of three.
People with diabetes are at increased risk of developing tuberculosis (TB), according to a review of published studies. As a result, the increasing prevalence of diabetes may threaten global efforts to control TB, suggest researchers at Harvard School of Public Health in Boston in the latest issue of the journal PLoS (Public Library of Science) Medicine.
Experts have raised concerns about the merging epidemics of diabetes and TB, especially in low- to middle-income countries such as India and China, which are experiencing the fastest increase in diabetes cases and the highest burden of TB in the world, write Drs. Christie Y. Jeon and Megan B. Murray.
Searching for studies over the past four decades on the relationship between diabetes and TB, Jeon and Murray found 13 studies involving more than 1.7 million participants, including 17,698 cases of TB.
Combining the data from some of these studies, the researchers calculated that having diabetes increases the risk of active TB by about a factor of three. A three-fold increased risk suggests that diabetes may already be responsible for more than 10 percent of TB cases in India and China, Jeon and Murray note.
An association between diabetes and TB is biologically plausible, the researchers maintain, given research showing that diabetes impairs the immune system, making it harder for the body to fight off infection.
Based on the data, Jeon and Murray say, global TB control efforts "should consider targeting patients with diabetes." Increased efforts to diagnose and treat diabetes might decrease the global burden of TB, which kills about 1.6 million people each year, they suggest.
SOURCES: PLoS Medicine, July 2008, Reuters Health
Categories: Complications & Care, Diabetes, Diabetes, International, Research, Type 1 Issues, Type 2 Issues
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Comments
Perhaps Denise Faustman with her research involving the BCG vaccine is on to something?
As a person with Type 1 diabetes, these articles frustrate me, because they do not differentiate between Type 1 and Type 2. Types 1 and 2 diabetes are two different diseases/conditions, with different causes, dynamics, etc. Yes, they both have some things in common, such as complications from long term lack of blood glucose control.
But Type 1 (formerly called "juvenile diabetes") is generally an autoimmune condition caused by the body's immune system attacking and destroying its own insulin producing cells in the pancreas, the onset occurring within 3-4 months.
Type 2 (formerly called "adult-onset diabetes") is an insulin resistance condition in which the body continues to produce insulin, but the body's muscle tissue becomes resistant to that insulin needed to allow the glucose in to use as fuel. Type 2 usually develops over a 7-10 year period of time.
The ratio of Type 1 to Type 2 is currently about 1:20, with type 1 being fairly consistent throughout all population groups, while Type 2 varies greatly in different population groups. Type 2 is the type that is increasing and in epidemic numbers.
All articles about "diabetes" or "people with diabetes" should clearly and repeatedly state which type they are talking about, and whether the information is referring to Type 1 or Type 2, or occasionally both.
I am sure that the original researchers are well aware of the two types of diabetes you refer to (infact there are more than 2 types, MODY and gestational diabetes are other forms of diabetes although a lot less common). As all types of diabetes cause an impairment in an individuals immune responses to some degree it is both of the types you have mentioned who are at an increased risk of developing active TB, however obviously only those who are actually exposed to and infected with TB will ever face the consequences of this increased risk of developing active TB.
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