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Diabetes Mellitus Increases the Risk of Active Tuberculosis: A Systematic Review of 13 Observational Studies
Open accessAbstract
BACKGROUND: Several studies have suggested that diabetes mellitus (DM) increases the risk of active tuberculosis (TB). The rising prevalence of DM in TB-endemic areas may adversely affect TB control. We conducted a systematic review and a meta-analysis of observational studies assessing the association of DM and TB in order to summarize the existing evidence and to assess methodological quality of the studies. METHODS AND FINDINGS: We searched the PubMed and EMBASE databases to identify observational studies that had reported an age-adjusted quantitative estimate of the association between DM and active TB disease. The search yielded 13 observational studies (n = 1,786,212 participants) with 17,698 TB cases. Random effects meta-analysis of cohort studies showed that DM was associated with an increased risk of TB (relative risk = 3.11, 95% CI 2.27-4.26). Case-control studies were heterogeneous and odds ratios ranged from 1.16 to 7.83. Subgroup analyses showed that effect estimates were higher in non-North American studies. CONCLUSION: DM was associated with an increased risk of TB regardless of study design and population. People with DM may be important targets for interventions such as active case finding and treatment of latent TB and efforts to diagnose, detect, and treat DM may have a beneficial impact on TB control.
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“This contrasts with studies on pulmonary TB (PTB) where DM is known to increase the risk of developing the disease, 32”
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Metadata
- Authors
- Jeon, C. Y., & Murray, M. B.
- Affiliations
- Harvard University (US)
- Corresponding author
- Jeon, Christie Y
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2008-07-15
- Volume
- 5
- Issue
- 7
- Pages
- e152
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC2459204
- OpenAlex
- W2104101804
- Cited by
- 1,486
- References
- 47
- Citations by year
- 2026: 51 · 2025: 68 · 2024: 83 · 2023: 87 · 2022: 104 · 2021: 102 · 2020: 100 · 2019: 122 · 2018: 114 · 2017: 116 · 2016: 114 · 2015: 91 · 2014: 87 · 2013: 75 · 2012: 66
- FWCI
- 4.02
- Type
- journal article
- Language
- en
- Update notices
- correction (2008-08-26)
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Infectious Diseases › Diagnosis and treatment of tuberculosis
- Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
- Keywords
- diabetes mellitus, active tuberculosis, tuberculosis risk, comorbidities, tuberculosis control, latent tuberculosis infection, active case finding
- MeSH terms
- Diabetes Mellitus, Type 2, Humans, Risk Factors, Tuberculosis, Diabetes Complications
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