The prevalence of diabetes among tuberculosis patients in Denmark

Prevalence and Risk Factors of Diabetes in Patients with Active Pulmonary Tuberculosis: A Cross-Sectional Study in Two Financially Affluent China Cities

Background

Tuberculosis (TB) and diabetes mellitus (DM) present a dual burden to public health. The screening of DM in TB patients may aid in the early detection and management of diabetes, ultimately improving treatment outcomes for those with the comorbidity of TB-DM. We aim to examine the prevalence and identify risk factors of diabetes in individuals with active pulmonary tuberculosis (PTB) in financially affluent China cities.

Methods

A cross-sectional survey was conducted in adult patients with highly suspected TB in two cities of China, spanning from May 9, 2023, to June 30, 2023. We compare the clinical characteristics, nutrition status, fasting blood glucose (FBG) level, living style, and knowledge of TB and DM at admission between patients with and without DM. Univariate and multivariate logistic regression analyses were employed to identify risk factors associated with TB-DM comorbidities.

Results

Of the 322 patients diagnosed with pulmonary tuberculosis (PTB), 54 individuals (16.8%) had comorbid diabetes mellitus (DM). This included 43 males (13.4%) and 11 females (3.4%). The average age was 55.44 ± 12.36 in DM patients and 46.09 ± 16.87 in non-DM patients. A multivariate logistic regression analysis revealed that male (adjusted odds ratio [aOR]=3.29, 95% confidence interval [CI]: 1.05-10.30), age older than 47 years (aOR = 1.04, 95% CI: 1.01-1.07), having a family history of diabetes (aOR = 5.09, 95% CI: 1.28-20.32), and an elevated random blood glucose level (aOR = 1.6, 95% CI: 1.38-1.86) were risk factors for DM in patients with PTB. Furthermore, it was found that diabetes awareness (aOR = 0.07, 95% CI: 0.03-0.21) and zero, light to moderate alcohol consumption were associated with a lower risk of diabetes.

Conclusion

Diabetes is prevalent in patients with active PTB. Screening and raising awareness of DM are recommended, particularly in men after middle age with a family history of diabetes and elevated random blood glucose. Early diagnosis of diabetes and effective diabetes prevention may reduce the dual burden of TB-DM comorbidity.

Prevalence and Associated Factors of Diabetes Mellitus Type 2 Among Tuberculosis Patients in Muscat, Oman, 2017-2020

Objectives

Diabetes mellitus (DM) and tuberculosis (TB) are global public health concerns and leading causes of mortality and morbidity worldwide. Coinfection is known to complicate TB control and outcomes. However, there is no national study regarding the prevalence of DM among TB patients in Oman. The objective of the current study was to assess the prevalence of DM and its associated factors among TB patients in Muscat, Oman.

Methods

We conducted an analytical cross-sectional study using secondary data from the electronic system of the Ministry of Health (Al-Shifa 3+). It includes all adult TB patients in Muscat, from 2017-2020. Sociodemographic data, clinical characteristics, and comorbidities of TB patients were collected. SPSS with 95% CI and p-value ≤ 0.05 was used for statistical analysis.

Results

Of 426 TB cases, the prevalence of DM was 27.0%. The associated factors of DM were age group 40-54 years (odds ratio (OR) = 9.08, 95% CI: 4.16-19.84) and ≥ 55 years (OR = 11.35, 95% CI: 5.19-24.82), male (OR = 2.35, 95% CI: 1.45-3.81), being married (OR = 13.18, 95% CI: 4.72-36.84), being employed (OR = 2.30, 95% CI: 1.19-4.47), and Bangladeshi (OR = 7.08, 95% CI: 2.50-20.12) or Indian (OR = 6.14, 95% CI: 2.40-15.70) nationality. The absence of Bacillus Calmette-Guérin scar (OR = 2.06, 95% CI: 1.19-3.56), death (OR = 7.08, 95% CI: 1.26-7.82), and cured after TB treatment (OR = 3.02, 95% CI 1.71-5.31) showed significant association. Also, smoking (OR = 2.93, 95% CI: 1.81-4.76), drinking alcohol (OR = 1.79, 95% CI: 1.10-2.91), hypertension (OR = 10.45, 95% CI: 5.29-20.64), heart disease (OR = 8.50, 95% CI: 1.69-42.77), and renal disease (OR = 4.84, 95% CI: 1.71-13.64) contributed to the study's comorbidities. Old age (adjusted OR = 2.30, 95% CI: 1.72-3.06) and hypertension (adjusted OR = 5.21, 95% CI: 2.28-11.87) were found to be predictors of DM among TB patients.

Conclusions

The prevalence of DM among TB patients in Muscat is high. Integrated systematic bidirectional TB-DM screening is needed. Furthermore, special attention is required for associated factors when managing these comorbidities.

Prevalence of Diabetes Mellitus among Patients with Tuberculosis and Its Associated Factors in Sana'a, Yemen, 2021

Diabetes mellitus (DM) is one of tuberculosis' (TB) ending barriers. TB patients with DM are at a higher risk than non-diabetes patients to develop complication, relapse and die. In Yemen, information on TB-DM comorbidity is lacking. This study aimed to determine the prevalence and associated factors of diabetes among TB patients at the National Tuberculosis Center (NTC) in Sana'a. A facility-based cross-sectional study was conducted. All TB patients aged >15 years who attended the NTC from July to November 2021 were screened for DM. Socio-demographic and behavioral information were collected through face-to-face interviews using questionnaires. A total of 331 TB patients were enrolled, 53% were males, 58% aged <40 years, and 74% were newly diagnosed with TB. Overall, DM prevalence was 18%. Higher rates of DM were found among TB patients that were male (OR = 3.0; 95% CI; 1.4-6.7), ≥50 years of age (OR = 10.8; 95% CI; 4.3-27.3), and those with a family history of diabetes (OR = 3.4; 95% CI; 1.6-6.9). Almost one fifth of TB patients had DM. The early detection of DM through immediate screening after a TB diagnosis and periodically during the course of treatment is crucial for TB patients' optimal care. Dual diagnostics for reducing the dual burden of TB-DM comorbidity is recommended.

Prevalence and associated factors of diabetes mellitus among patients with tuberculosis in South Korea from 2011 to 2018: a nationwide cohort study

OBJECTIVES

This study aimed to identify the prevalence of diabetes mellitus (DM) among patients with tuberculosis (TB) using a nationwide cohort in South Korea.

DESIGN

A retrospective cohort study.

SETTING

This study used the Korean Tuberculosis and Post-Tuberculosis cohort, which was constructed by linking the Korean National Tuberculosis Surveillance, National Health Information Database (NHID) and Statistics Korea data for the causes of death.

PARTICIPANTS

During the study period, all notified patients with TB with at least one claim in the NHID were included. Exclusion criteria were age less than 20 years, drug resistance, initiation of TB treatment before the study period and missing values in covariates.

OUTCOME MEASURES

DM was defined as having at least two claims of the International Classification of Diseases (ICD) code for DM or at least one claim of the ICD code for DM and prescription of any antidiabetic drugs. Newly diagnosed DM (nDM) and previously diagnosed DM (pDM) were defined as DM diagnosed after and before TB diagnosis, respectively.

RESULTS

A total of 26.8% (70 119) of patients were diagnosed with DM. The age-standardised prevalence increased as age increased or income decreased. Patients with DM were more likely to be men, older, had the lowest income group, had more acid-fast bacilli smear and culture positivity, had a higher Charlson Comorbidity Index score and had more comorbidities compared with patients without DM. Approximately 12.5% (8823) patients had nDM and 87.4% (61 296) had pDM among those with TB-DM.

CONCLUSIONS

The prevalence of DM among patients with TB was considerably high in Korea. To achieve the goal of TB control and improve the health outcomes of both TB and DM, integrated screening of TB and DM and care delivery in clinical practice are necessary.

A Case Report of Burkholderia mallei Infection Leading to Pneumonia

BACKGROUND

Glanders is a rare zoonotic disease caused by Burkholderia mallei. Humans can be infected by B. mallei, which causes cutaneous lymphadenitis and pneumonia, leading to sepsis and death in severe cases.

CASE PRESENTATION

We report a case of a 60-year-old male who was diagnosed with glanders. The patient who had a history of diabetes presented with cough, expectoration, and fever. Computed tomography (CT) imaging showed B. mallei infection in the right upper lobe of the lung with mediastinal lymph node involvement and the lingual segment of the left lung. Moreover, the posterior basal segment of the lower lobe of both lungs had inflammation. Subsequently, B. mallei infection was confirmed by lymph node biopsy and bronchoalveolar lavage multiplex PCR-based targeted gene sequencing. After meropenem treatment, the patient was discharged, and CT imaging showed reduced absorption of pulmonary inflammatory lesions.

CONCLUSIONS

Glanders is a rare disease that can cause skin infection, lymphadenitis, and pneumonia, and in severe cases, it can be life-threatening. The diagnosis of this disease mainly relies on microbiological culture and pathological biopsy. Diagnosis is also facilitated by multiplex PCRbased targeted gene sequencing. Glanders is treated with cephalosporins, carbapenems, and other sensitive antibiotics.

Correlations of Salivary and Blood Glucose Levels among Six Saliva Collection Methods

Background: Saliva has been studied as a better indicator of disorders and diseases than blood. Specifically, the salivary glucose level is considered to be an indicator of diabetes mellitus (DM). However, saliva collection methods can affect the salivary glucose level, thereby affecting the correlation between salivary glucose and blood glucose. Therefore, this study aims to identify an ideal saliva collection method and to use this method to determine the population and individual correlations between salivary glucose and blood glucose levels in DM patients and healthy controls. Finally, an analysis of the stability of the individual correlations is conducted. Methods: This study included 40 age-matched DM patients and 40 healthy controls. In the fasting state, saliva was collected using six saliva collection methods, venous blood was collected simultaneously from each study participant, and both samples were analyzed at the same time using glucose oxidase peroxidase. A total of 20 DM patients and 20 healthy controls were arbitrarily selected from the above participants for one week of daily testing. The correlations between salivary glucose and blood glucose before and after breakfast were analyzed. Finally, 10 DM patients and 10 healthy controls were arbitrarily selected for one month of daily testing to analyze the stability of individual correlations. Results: Salivary glucose levels were higher in DM patients than healthy controls for the six saliva collection methods. Compared with unstimulated saliva, stimulated saliva had decreased glucose level and increased salivary flow. In addition, unstimulated parotid salivary glucose was most correlated with blood glucose level (R² = 0.9153), and the ROC curve area was 0.9316, which could accurately distinguish DM patients. Finally, it was found that the correlations between salivary glucose and blood glucose in different DM patients were quite different. The average correlation before breakfast was 0.83, and the average correlation after breakfast was 0.77. The coefficient of variation of the correlation coefficient before breakfast within 1 month was less than 5%. Conclusion: Unstimulated parotid salivary glucose level is the highest and is most correlated with blood glucose level, which can be accurately used to distinguish DM patients. Meanwhile, the correlation between salivary glucose and blood glucose was found to be relatively high and stable before breakfast. In general, the unstimulated parotid salivary glucose before breakfast presents an ideal saliva collecting method with which to replace blood-glucose use to detect DM, which provides a reference for the prediction of DM.

Dysglycaemia among tuberculosis patients without known diabetes in a low-endemic setting

There is increasing evidence that diabetes mellitus is an important risk factor for tuberculosis (TB) and might affect TB-disease presentation as well as treatment response [1]. The hypothesis is that an impaired immune response in persons with diabetes mellitus facilitates infection with Mycobacterium tuberculosis and/or progression to TB, and reversely, M. tuberculosis infection may affect glycaemic control [2, 3]. Although the exact causality is unknown, this association between TB and diabetes mellitus is ominous, as the explosive rise in diabetes mellitus worldwide witnessed over the last decades could potentially counteract the positive effect of TB control efforts.

With a high prevalence of dysglycaemia (29.1%) among tuberculosis patients without previously known diabetes, this study highlights the importance of comanagement of tuberculosis and diabetes, even in a low-endemic settinghttps://bit.ly/3Gj0gmN