257322 High Risk of Pulmonary Tuberculosis Infection in Patients with Type 2 Diabetes: A Population-Based Cohort Study

Sunday, October 28, 2012

Hsiao-Yun Hu , Institute of Public Health & Department of Public Health, National Yang-Ming University, Taipei, Taiwan
Chen-Yi Wu , Division of Dermatology, Heping Fuyou Branch, Taipei City Hospital, Taipe, Taiwan
Nicole Huang , Institute of Hospital and Health Care Administration, National Yang Ming University, Taipei, Taiwan
Yiing-Jenq Chou, MD, PhD , Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
Dachen Chu , Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
Background: Tuberculosis (TB) remains a major cause of mortality in Asian countries. At the same time, the prevalence of diabetes is also noted to increase rapidly in these countries.. There have been evidences that revealed diabetes is a risk factor for TB, however, the magnitude and the temporal relationship remains unclear. The purpose of this study was to perform a nationwide population-based cohort study to investigate the risk of pulmonary TB infection in patients with type 2 diabetes. Methods: This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database. In total, 64,696 incident cases of type 2 diabetes patients and 129,392 controls matched on age and gender were recruited for the study from 1998 to 2009. Results: The incidence rate (IR) of TB (197 of 100,000 person-years) was significantly higher in the type 2 diabetes patients than that in controls (122 of 100,000 person-years) (IRR: 1.62; 95% CI: 1.48-1.78). Compared with the controls, the IRRs of TB in the cohort of type 2 diabetes patients were 2.01 within 1 year, 1.68 at 1-2 years, 1.66 at 3-5 years, and 1.35 at 5-8 years after incidence of diabetes. The multivariate Cox proportional hazards model revealed that type 2 diabetes (HR: 1.61, 95% CI: 1.46-1.76), age older than 65 years (HR: 3.99), male gender (HR: 2.71), and COPD (HR: 1.74) are independent risk factors for TB infections. Conclusion: Patients with type 2 diabetes is associated with an increased risk of pulmonary infection with TB.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
To evaluate the association between type 2 diabetes and subsequent risk of pulmonary TB from a national health insurance claim data.

Keywords: Diabetes, Tuberculosis

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee all aspects of this study including conceptualization, analyses, interpretations, and writing of the article.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.