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Diabetes a Cause of Tuberculosis in Developing Countries

By Daniel H. Rasolt

Posted: Tuesday, July 15, 2008

(Defeat Diabetes® News) -- A recent study indicates that diabetes increases the likelihood of developing active tuberculosis (TB). This result is most important for developing countries, where TB is common and diabetes is on the rise.
Active tuberculosis is an infectious bacterial disease most prevalent in poorer countries more prone to unsanitary conditions and deficient medical care. It is often fatal, and effects primarily the lungs and the central nervous system. There are 8.8 million new TB cases each year, and 1.6 million deaths from the disease. It is treatable with intensive antibacterial treatment, and in high risk countries, early detection and prevention is a very high priority on the medical agenda. This strategy, while partially effective, still does far from actually stopping the spread of TB, meaning new risk factors and strategies should be developed.
Diabetes mellitus, which accounts for both type 1 and type 2 diabetes, was shown in the study to increase the risk of developing TB. These same above countries, along with many more developed countries, have seen a large rise in diabetes cases over recent years. "Low- to middle-income countries (for example, India and China) have the highest burden of tuberculosis and are experiencing the fastest increase in diabetes prevalence," according to the study.
The "meta-analysis" was performed at the Harvard School of Public health, and accounted for 13 past studies, with 1,786,212 participants. 17,698 of the participants had TB.
Results of the study varied, with the connection between diabetes and TB being highest in developing countries, and lowest in North America. "How much diabetes increases the risk of developing active tuberculosis were highly variable, ranging from no effect to an increased risk of nearly 8-fold in one study." Overall though, "compared to people without diabetes, people with diabetes had a 3-fold increased risk of developing active tuberculosis."
The authors concluded that this connection between diabetes and TB was "a biologically plausible idea because, in experimental and clinical studies, diabetes was found to impair the immune responses needed to control bacterial infections." The fact that diabetes is on the rise in many of these high-risk TB countries makes treating diabetes, which is significantly neglected and poorly understood in developing countries, a higher priority.
Diabetes itself causes millions of deaths worldwide each year, but may be responsible for upwards of 10% of potentially fatal TB cases in heavily populated countries like China and India as well. The study concludes that "global tuberculosis control might benefit from active case finding and treatment of dormant tuberculosis in people with diabetes and from increased efforts to diagnose and treat diabetes."

Source: Defeat Diabetes Foundation: Jeon, Christie. Murray, Megan. PLoS Medicine. "Diabetes Mellitus Increases the Risk of Active Tuberculosis: A Systematic Review of 13 Observational Studies." July 2008.

Daniel H. Rasolt writes for Defeat Diabetes® News. Read more of his original content articles.

Copyright © 2008 Defeat Diabetes Foundation, Inc. All rights reserved.

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