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Study shows link between diabetes, TB
Many patients have both diseases
By MELISSA McEVER
The Brownsville Herald
Patients with type II diabetes are at a greater risk for contracting tuberculosis than other patients, and their cases are more severe and possibly more contagious, a group of researchers from the Rio Grande Valley and the Mexican state of Tamaulipas has concluded.
Self-reported type II diabetes is the most common risk factor for tuberculosis, according to a study by Blanca Restrepo, assistant epidemiology professor at the University of Texas School of Public Health?s Brownsville campus, and other researchers.
The study, to be published in the journal Epidemiology and Infection, also concluded that patients with diabetes were more likely to have active tuberculosis and resulting complications than other patients.
?Patients who have diabetes tend to present a more complicated, advanced tuberculosis,? Restrepo said. ?If a TB patient has diabetes, it takes longer for them to respond to treatment. ... It takes longer to clear the bacteria from sputum, and they?re more likely to be infectious to the community for a longer period of time.?
According to the study, about 28 percent of TB patients from Texas also had diabetes, and about 18 percent of Mexico residents had both conditions.
Researchers collected six years? worth of data from the Texas Department of State Health Services? Region 11, which includes the Rio Grande Valley, and from health departments in Tamaulipas. They analyzed data from about 5,000 patients, Restrepo said.
Diabetics might be more prone to severe cases of tuberculosis because their immune systems are impaired, making the disease harder to fight off, experts say.
Although other studies have suggested that a link exists between diabetes and tuberculosis, this study is the first to find a link this strong, said Dr. Joseph B. McCormick, regional dean for the UT School of Public Health?s Brownsville campus and senior author of the study.
?If this link continues to strengthen and grow, diabetes could be another underlying disease that increases the worldwide epidemic of tuberculosis,? McCormick said.
Conversely, he said, ?if we can lower the rate of diabetes, we could help with the local fight against tuberculosis.?
About 8 million new cases of tuberculosis were reported worldwide in 2004, according to the World Health Organization. On the border, the incidence of TB is about 12 cases per 100,000 people, and in Mexico, it?s about 45 cases per 100,000.
Tuberculosis cases are increasing in Hidalgo and Cameron counties, according to statistics from the Texas Department of State Health Services. In Cameron County, rates have gone from 16 per 100,000 in 2001 to nearly 18 per 100,000 in 2005, and the numbers have increased from 55 cases in 2001 to 68 in 2005.
In Hidalgo, the rate has increased from 13 per 100,000 in 2001 to 13.6 in 2005, and the numbers have jumped from 74 cases in 2001 to 92 in 2005.
The Hidalgo County Health Department puts the number higher, at more than 100, in 2005.
Combined, the two counties had about 60 confirmed new cases as of July 2006, according to DSHS.
Most of the tuberculosis patients seen at the Hidalgo County Health Department, which has a dedicated TB clinic, have multiple health problems, said Eduardo Olivarez, chief executive officer for the health department.
These diagnoses include HIV, cardiovascular problems and pulmonary diseases, as well as diabetes, he said.
?Probably about 100 patients we?ve seen during the last five years had diabetes,? Olivarez said.
Olivarez called the researchers? study ?landmark? and said he hoped it would translate to treatment of both diseases.
?We need to look at ... how well patients follow through on their daily medication and physician orders for both (conditions),? he said.
McCormick said doctors should start screening diabetes patients for tuberculosis if they have telltale symptoms and screen TB patients for diabetes.
The study should help arm health-care providers with more information about the relationship between the two conditions, Restrepo said.
?It should warn the physician that the case is going to be more difficult to treat,? she said. ?Maybe they need more time, maybe they have a drug-resistant case. We also need to assess if diabetics are truly more infectious than non-diabetics.?
The study was published on the Epidemiology and Infection Web site in July but has not yet appeared in print. McCormick said that the publishing company, Cambridge University Press, has not yet specified a date for publication.
http://www.brownsvilleherald.com/ts_...998_0_10_0_M36
By MELISSA McEVER
The Brownsville Herald
Patients with type II diabetes are at a greater risk for contracting tuberculosis than other patients, and their cases are more severe and possibly more contagious, a group of researchers from the Rio Grande Valley and the Mexican state of Tamaulipas has concluded.
Self-reported type II diabetes is the most common risk factor for tuberculosis, according to a study by Blanca Restrepo, assistant epidemiology professor at the University of Texas School of Public Health?s Brownsville campus, and other researchers.
The study, to be published in the journal Epidemiology and Infection, also concluded that patients with diabetes were more likely to have active tuberculosis and resulting complications than other patients.
?Patients who have diabetes tend to present a more complicated, advanced tuberculosis,? Restrepo said. ?If a TB patient has diabetes, it takes longer for them to respond to treatment. ... It takes longer to clear the bacteria from sputum, and they?re more likely to be infectious to the community for a longer period of time.?
According to the study, about 28 percent of TB patients from Texas also had diabetes, and about 18 percent of Mexico residents had both conditions.
Researchers collected six years? worth of data from the Texas Department of State Health Services? Region 11, which includes the Rio Grande Valley, and from health departments in Tamaulipas. They analyzed data from about 5,000 patients, Restrepo said.
Diabetics might be more prone to severe cases of tuberculosis because their immune systems are impaired, making the disease harder to fight off, experts say.
Although other studies have suggested that a link exists between diabetes and tuberculosis, this study is the first to find a link this strong, said Dr. Joseph B. McCormick, regional dean for the UT School of Public Health?s Brownsville campus and senior author of the study.
?If this link continues to strengthen and grow, diabetes could be another underlying disease that increases the worldwide epidemic of tuberculosis,? McCormick said.
Conversely, he said, ?if we can lower the rate of diabetes, we could help with the local fight against tuberculosis.?
About 8 million new cases of tuberculosis were reported worldwide in 2004, according to the World Health Organization. On the border, the incidence of TB is about 12 cases per 100,000 people, and in Mexico, it?s about 45 cases per 100,000.
Tuberculosis cases are increasing in Hidalgo and Cameron counties, according to statistics from the Texas Department of State Health Services. In Cameron County, rates have gone from 16 per 100,000 in 2001 to nearly 18 per 100,000 in 2005, and the numbers have increased from 55 cases in 2001 to 68 in 2005.
In Hidalgo, the rate has increased from 13 per 100,000 in 2001 to 13.6 in 2005, and the numbers have jumped from 74 cases in 2001 to 92 in 2005.
The Hidalgo County Health Department puts the number higher, at more than 100, in 2005.
Combined, the two counties had about 60 confirmed new cases as of July 2006, according to DSHS.
Most of the tuberculosis patients seen at the Hidalgo County Health Department, which has a dedicated TB clinic, have multiple health problems, said Eduardo Olivarez, chief executive officer for the health department.
These diagnoses include HIV, cardiovascular problems and pulmonary diseases, as well as diabetes, he said.
?Probably about 100 patients we?ve seen during the last five years had diabetes,? Olivarez said.
Olivarez called the researchers? study ?landmark? and said he hoped it would translate to treatment of both diseases.
?We need to look at ... how well patients follow through on their daily medication and physician orders for both (conditions),? he said.
McCormick said doctors should start screening diabetes patients for tuberculosis if they have telltale symptoms and screen TB patients for diabetes.
The study should help arm health-care providers with more information about the relationship between the two conditions, Restrepo said.
?It should warn the physician that the case is going to be more difficult to treat,? she said. ?Maybe they need more time, maybe they have a drug-resistant case. We also need to assess if diabetics are truly more infectious than non-diabetics.?
The study was published on the Epidemiology and Infection Web site in July but has not yet appeared in print. McCormick said that the publishing company, Cambridge University Press, has not yet specified a date for publication.
http://www.brownsvilleherald.com/ts_...998_0_10_0_M36
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