PT  - JOURNAL ARTICLE
AU  - Roula S Zahr
AU  - Ryan A Peterson
AU  - Linnea A Polgreen
AU  - Joseph E Cavanaugh
AU  - Douglas B Hornick
AU  - Kevin L Winthrop
AU  - Philip M Polgreen
TI  - Diabetes as an increasingly common comorbidity among patient hospitalizations for tuberculosis in the USA
AID  - 10.1136/bmjdrc-2016-000268
DP  - 2016 Oct 01
TA  - BMJ Open Diabetes Research & Care
PG  - e000268
VI  - 4
IP  - 1
4099  - http://drc.bmj.com/content/4/1/e000268.short
4100  - http://drc.bmj.com/content/4/1/e000268.full
SO  - BMJ Open Diab Res Care2016 Oct 01; 4
AB  - Objective Diabetes is a risk factor for active tuberculosis (TB). The purpose of this paper was to estimate the risk of hospitalization for TB with and without a secondary diagnosis of diabetes in groups with different ethnic backgrounds.Research design and methods We used the Nationwide Inpatient Sample from 1998 to 2011, identifying all patients with a primary diagnosis of TB and/or a secondary diagnosis of diabetes (type 1 or type 2) or HIV. Next, we performed logistic regression to investigate the association of diabetes status, HIV status, and race (and the interaction of diabetes and race) with the risk of hospitalization with a primary diagnosis of TB. We also included a time covariate, to determine whether potential risk factors changed during the study period.Results Controlling for HIV status, diabetes did not increase the odds of TB in white and black patients. However, in Hispanic and Asian/Pacific Islander patients, diabetes increased the odds of TB by a factor of 1.7 (95% CI 1.51 to 1.83). Asian/Pacific Islanders who had diabetes but not HIV experienced 26.4 (95% CI 23.1 to 30.1) times the odds of TB relative to the white males without diabetes or HIV. In addition, the percent of TB cases that belong to these high-risk groups (Asian/Pacific Islander/Hispanic diabetics) has more than doubled from 4.6% in 1998 to 9.6% in 2011.Conclusions In specific demographic groups, diabetes was a strong risk factor for hospital admissions for TB.