Mortality and related risk factors in the co-presentation of tuberculosis and type 2 diabetes mellitus: a
Po-Tsang Chen1,2, Nai-Cheng Yeh2, Shih-Feng Weng3,4,5
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Taiwan.
Objective:
Patients with type 2 diabetes mellitus (T2DM) are often immunosuppressed and susceptible to infectious diseases. We investigated the mortality and related risk factors of active TB disease in patients with T2DM in Taiwan.
Materials And Methods:
The data of 1258 patients diagnosed with both T2DM and active TB disease from January 1 to December 31, 2002 (T2DM-TB group) were retrieved from the Taiwan National Health Insurance Research Database. Patients in the T2DM-TB group were matched by age, sex, and comorbidities to a control group of 10,064 T2DM patients without TB disease (T2DM group). Patients were followed up since TB diagnosis until death or 31 December 2011. Cox proportional-hazards regression analysis was employed to compare the risk of death between the T2DM group and the T2DM-TB group.
Results:
A total of 101,837 potentially eligible patients were included in the study. After 1:10 propensity score matching, 1,258 patients were classified in the T2DM-TB group and 10,064 patients in the T2DM group. After adjustment for age, sex and comorbidities, the T2DM-TB group showed a 2.16-fold higher mortality risk than the T2DM group (95% CI = 1.83-2.56, p < .001). The mortality risk remained higher after stratification by year. The log-rank test indicated that male sex, age ≥60 years, hypertension and heart failure were independent risk factors.
Conclusions:
TB increases mortality risk in patients with T2DM on long-term follow-up. The independent risk factors for mortality in patients with concurrent T2DM and TB disease include male sex, age ≥60 years, hypertension and heart failure.KEY MESSAGESThe co-presentation of T2DM and TB is an important emerging issue, especially in Asia.This study showed mortality risk was significantly higher in the T2DM-TB group compared with the T2DM group on long-term follow-up.Increased medical attention is necessary for patients with T2DM and a history of TB disease.
More Related Videos
10:04Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
09:02An Experimental Model to Study Tuberculosis-Malaria Coinfection upon Natural Transmission of Mycobacterium tuberculosis and Plasmodium berghei
Published on: February 17, 2014
Related Concept Videos
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:22Diabetes Mellitus: Type 2 and Gestational
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...