Diabetes screen during tuberculosis contact investigations highlights opportunity for new diabetes diagnosis and reveals metabolic differences between ethnic groups

• Published in: Tuberculosis (Edinburgh, Scotland) Scotland), 2018-12, Vol.113, p.10-18
• Main Authors: Restrepo, Blanca I., Kleynhans, Léanie, Salinas, Alejandra B., Abdelbary, Bassent, Tshivhula, Happy, Aguillón-Durán, Genesis P., Kunsevi-Kilola, Carine, Salinas, Gloria, Stanley, Kim, Malherbe, Stephanus T., Maasdorp, Elizna, Garcia-Viveros, Moncerrato, Louw, Ilze, Garcia-Oropesa, Esperanza M., Lopez-Alvarenga, Juan Carlos, Prins, John B., Walzl, Gerhard, Schlesinger, Larry S., Ronacher, Katharina
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers - blood; Black People; Blood Glucose - metabolism; Cardiovascular; Cholesterol; Contact Tracing; Contraceptives; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - ethnology; Diagnosis; Dyslipidemias - blood; Dyslipidemias - diagnosis; Dyslipidemias - ethnology; Ethnic; Ethnic factors; Female; Glycated Hemoglobin - metabolism; Health risks; Heterogeneity; Hispanic or Latino; Humans; Lipids - blood; Male; Mass Screening - methods; Metabolism; Mexico - epidemiology; Middle Aged; Minority & ethnic groups; Patients; Prediabetic State - blood; Prediabetic State - diagnosis; Prediabetic State - ethnology; Prevalence; Risk analysis; Risk factors; Smoking; Sociodemographics; South Africa - epidemiology; Texas - epidemiology; Tuberculosis; Tuberculosis - blood; Tuberculosis - diagnosis; Tuberculosis - ethnology
• ISSN: 1472-9792; 1873-281X; 1873-281X
• DOI: 10.1016/j.tube.2018.08.007

Type 2 diabetes (T2D) is a prevalent risk factor for tuberculosis (TB), but most studies on TB-T2D have focused on TB patients, been limited to one community, and shown a variable impact of T2D on TB risk or treatment outcomes. We conducted a cross-sectional assessment of sociodemographic and metabolic factors in adult TB contacts with T2D (versus no T2D), from the Texas-Mexico border to study Hispanics, and in Cape Town to study South African Coloured ethnicities. The prevalence of T2D was 30.2% in Texas-Mexico and 17.4% in South Africa, with new diagnosis in 34.4% and 43.9%, respectively. Contacts with T2D differed between ethnicities, with higher smoking, hormonal contraceptive use and cholesterol levels in South Africa, and higher obesity in Texas-Mexico (p