Diabetes Ups TB Risk in Children and Adolescents

A new study conducted in the TB-endemic Western Cape province finds almost one in three children and adolescents with type 1 diabetes had positive TB skin tests and are at risk of developing active, infectious TB.

Dr. E.A. Webb of the Desmond Tutu Tuberculosis Center in Cape Town and colleagues evaluated the prevalence of TB among 258 patients age 21 and under with insulin-dependent type 1 diabetes. Prevalence of TB infection was 29.8 percent in the group, with active disease confirmed in 3.48 percent of patients. Approximately 6.2 percent of participants were previously treated for TB.

According to the researchers, TB prevalence increased from 7.8 percent at five years to 12.5 percent at 10 years after diagnosis of diabetes. Observed TB prevalence among type 1 diabetics was more than 6.8 times greater than the general population prevalence, the team reported.

Poor control of diabetes and contact with a TB source were associated with a 1.39- and 2.78-times higher risk of TB. However, it is not clear whether poor blood sugar control predisposes diabetics to developing TB disease following infection, or whether the poor blood sugar control is a consequence of TB disease, said the researchers.

"Routine TB screening of children with type 1 diabetes may be indicated in settings highly endemic for TB," the team concluded.

The study, "High Prevalence of Mycobacterium tuberculosis Infection and Disease in Children and Adolescents With Type 1 Diabetes Mellitus," was published in the International Journal of Tuberculosis and Lung Diseases (2009;13(7):868-874).

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