Poor Diabetes Control Puts Elderly At Risk for TB

Older adults with poorly controlled diabetes may have three times the risk of developing tuberculosis than those who achieve better diabetes control, study findings suggest.

Tuberculosis (TB) is a highly contagious and potentially deadly airborne bacterial infection that commonly involves the lungs. Symptoms include cough lasting 3 weeks or longer, weakness, tiredness, weight loss, fever, chills, and night sweats.

Dr. Chi C. Leung of Wanchai Chest Clinic, Wanchai, Hong Kong, stated that,  "For unknown reasons," diabetes is known to increase the risk of TB. However, few studies have examined specifically the impact of diabetes control.

To investigate, Leung’s team followed 42,116 residents of Hong Kong aged 65 and older for 5 years.

Diabetes control, as determined by blood levels of hemoglobin A1C, appeared to be the predominant determinant of increased TB risk, they report in the American Journal of Epidemiology. A1C levels at or above 7 percent identified poor control while levels less than 7 percent identified good diabetes control.

Compared with elderly individuals without diabetes, those with poorly controlled diabetes were 2.5 times more likely to have active TB. Diabetics with poor, compared with good, control of their blood sugar had 3 times the risk for TB. Risk did not change when the investigators accounted for sex, age, and other factors associated with the risk for TB.

Countries with a high prevalence of tuberculosis may want to consider regular monitoring of hemoglobin A1C among people with diabetes to better identify those at increased risk for tuberculosis, the researchers suggest.

Further research is needed to assess similar risk associations among younger people with diabetes, Leung said.
American Journal of Epidemiology, June 15, 2008

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