Research conducted by a team of academics, physicians and government health officials has found that people with diabetes can reduce the risk of developing tuberculosis (TB) by controlling their blood-sugar levels.
The research team led by Centers for Disease Control (CDC) physician Lee Pin-hui (李品慧), National Taiwan University (NTU) College of Public Health associate professor Lin Hsien-ho (林先和) and physician Chiang Chen-yuan (江振源) at the International Union Against Tuberculosis and Lung Disease found that poor control of blood-sugar levels can increase the risk of TB onset.
Earlier studies have suggested that the risk of TB onset in people with diabetes is two to three times higher than those without diabetes, Lee said, adding that about one in five TB patients have diabetes and TB patients with diabetes have higher death and relapse rates during TB treatment.
Analyzing data collected from community-based health screening services on more than 120,000 people and conducting a five-year follow-up study, the team discovered that people with diabetes who controlled their blood-sugar levels poorly — a fasting blood sugar level above 130 miligrams per deciliter (mg/dL) — are twice more likely to develop TB onset than those who controlled their blood-sugar levels — a fasting blood sugar level under 130mg/dL.
“The risk of developing TB in people with diabetes who controlled their blood-sugar level properly is close to that of people without diabetes,” she said.
“About 10,000 new cases of TB are reported each year in Taiwan, but the disease does not randomly occur; the high-risk group includes people with diabetes and people who smoke or frequently consume alcohol,” Lin said.
In addition, people who often visit hospitals are more likely to be exposed to people with TB, so people should avoid going to hospitals unless it is necessary, he said, adding that people with latent TB infection can still prevent active TB by receiving preventive treatment.
Chiang said diabetes is a well-known risk factor for TB, but added that the study might be the first to provide evidence of the effect of blood-sugar level control on TB.
Early diabetes diagnosis and diabetes control have the potential to complement tuberculosis control efforts, Chiang added.
Lee said assuming that their findings imply a causal effect of blood-sugar control on tuberculosis, 7.5 percent of TB cases could be prevented if people with diabetes maintained good blood-sugar control.
The team’s findings were published in the online journal PLOS Medicine this month, titled Glycemic Control and the Risk of Tuberculosis: A Cohort Study.
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