Journal Article

Diabetes mellitus among adults with tuberculosis in the USA, 2010–2017

Kammerer, J Steve, Haddad, Maryam B, Armstrong, Lori R

2020

Overview

IntroductionTo describe diabetes trends among adults with incident tuberculosis (TB) disease and examine diabetes-associated TB characteristics and patient outcomes in the USA.Research design and methodsWe examined all 71 855 persons aged ≥20 years with incident TB disease reported to the National Tuberculosis Surveillance System during 2010–2017. We performed multivariable logistic regression, comparing characteristics and outcomes among patients with TB reported to have diabetes and those whose diabetes status was unknown.ResultsAn overall 18% (n=13 281) of the 71 855 adults with incident TB disease were reported as also having diabetes; the annual proportion increased from 15% in 2010 to 22% in 2017. Among patients aged ≥45 years with both TB and diabetes, the adjusted OR for cavitary or sputum smear-positive TB was 1.7 and 1.5, respectively (95% CIs 1.5 to 1.8 and 1.4 to 1.6). Patients with TB and diabetes had 30% greater odds of dying and took longer to achieve negative Mycobacterium tuberculosis cultures and complete treatment.ConclusionsThe prevalence of reported diabetes among adults with TB disease has increased. Having diabetes as a comorbidity negatively affects patient outcomes. In accordance with national recommendations, all patients aged ≥45 years and all younger patients who have risk factors for diabetes should be screened for diabetes at the start of TB treatment.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Age / Comorbidity / Diabetes / Drug use / Epidemiology / Epidemiology/Health Services Research / Ethnicity / Health surveillance / Hispanic people / HIV / Homeless people / Human immunodeficiency virus / Infections / Kidney diseases / Pacific Islander people / Patients / Public health / Race / Risk factors / Tuberculosis