Dataset Information

Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study.

ABSTRACT:

Objective

Previous studies that have found an increased risk for tuberculosis (TB) in people with diabetes mellitus (DM) have been conducted in segments of the population and have not adjusted for important potential confounders. We sought to determine the RR for TB in the presence of DM in a national population with data on confounding factors in order to inform the decision-making process about latent tuberculosis infection (LTBI) screening in people with diabetes.

Design

Whole population historical cohort study.

Setting

All Australian States and Territories with a mean TB incidence of 5.8/100?000.

Participants

Cases of TB in people with DM were identified by record linkage using the National Diabetes Services Scheme Database and TB notification databases for the years 2001-2006.

Primary and secondary outcome measures

Primary outcome was notified cases of TB. Secondary outcome was notified cases of culture-confirmed TB. RR of TB was estimated with adjustment for age, sex, TB incidence in country of birth and indigenous status.

Results

There were 6276 cases of active TB among 19?855?283 people living in Australia between 2001 and 2006. There were 271 (188 culture positive) cases of TB among 802?087 members of the DM cohort and 130 cases of TB among 273?023 people using insulin. The crude RR of TB was 1.78 (95% CI 1.17 to 2.73) in all people with DM and 2.16 (95% CI 1.19 to 3.93) in people with DM using insulin. The adjusted RRs were 1.48 (95% CI 1.04 to 2.10) and 2.27 (95% CI 1.41 to 3.66), respectively.

Conclusions

The presence of DM alone does not justify screening for LTBI. However, when combined with other risk factors for TB, the presence of DM may be sufficient to justify screening and treatment for LTBI.

SUBMITTER: Dobler CC

PROVIDER: S-EPMC3282295 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study.

Dobler Claudia Caroline CC Flack Jeffrey Ronald JR Marks Guy Barrington GB

BMJ open 20120213 1

<h4>Objective</h4>Previous studies that have found an increased risk for tuberculosis (TB) in people with diabetes mellitus (DM) have been conducted in segments of the population and have not adjusted for important potential confounders. We sought to determine the RR for TB in the presence of DM in a national population with data on confounding factors in order to inform the decision-making process about latent tuberculosis infection (LTBI) screening in people with diabetes.<h4>Design</h4>Whole ...[more]

PMID: 22331390

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Project description:BackgroundColorectal cancer (CRC) incidence is increasing among young adults below screening age, despite the effectiveness of screening in older populations. Individuals with diabetes mellitus are at increased risk of early-onset CRC. We aimed to determine how many years earlier than the general population patients with diabetes with/without family history of CRC reach the threshold risk at which CRC screening is recommended to the general population.Methods and findingsA nationwide cohort study (follow-up:1964-2015) involving all Swedish residents born after 1931 and their parents was carried out using record linkage of Swedish Population Register, Cancer Registry, National Patient Register, and Multi-Generation Register. Of 12,614,256 individuals who were followed between 1964 and 2015 (51% men; age range at baseline 0-107 years), 162,226 developed CRC, and 559,375 developed diabetes. Age-specific 10-year cumulative risk curves were used to draw conclusions about how many years earlier patients with diabetes reach the 10-year cumulative risks of CRC in 50-year-old men and women (most common age of first screening), which were 0.44% and 0.41%, respectively. Diabetic patients attained the screening level of CRC risk earlier than the general Swedish population. Men with diabetes reached 0.44% risk at age 45 (5 years earlier than the recommended age of screening). In women with diabetes, the risk advancement was 4 years. Risk was more pronounced for those with additional family history of CRC (12-21 years earlier depending on sex and benchmark starting age of screening). The study limitations include lack of detailed information on diabetes type, lifestyle factors, and colonoscopy data.ConclusionsUsing high-quality registers, this study is, to our knowledge, the first one that provides novel evidence-based information for risk-adapted starting ages of CRC screening for patients with diabetes, who are at higher risk of early-onset CRC than the general population.

Dataset Information

Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study.

Objective

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study.

Similar Datasets

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