The relationship between diabetes and tuberculosis in Saskatchewan: comparison of registered Indians and other Saskatchewan people.
BACKGROUND
Saskatchewan Aboriginal people are experiencing epidemics of both type 2 diabetes (T2DM) and tuberculosis (TB). The purpose of this study was to determine if a relationship exists between diabetes and TB in Saskatchewan and to establish whether there is a difference in the degree of any association between Aboriginal and non-Aboriginal people.


METHODS
Utilizing Saskatchewan Health databases, TB incidence (cases identified from 1986-2001) was compared between four subpopulations identified from 1991-1995: Registered Indians (RI) with and without diabetes, and other Saskatchewan people (OSKP) with and without diabetes.


RESULTS
Diabetic women aged 20-59 years had higher average annual incidence rates of TB than non-diabetic women, but within-population rate ratios of TB in diabetic versus non-diabetic women were only significant in those aged 50-59 (2.7 [CI 1.28, 5.72] in RI and 3.9 [CI 1.58, 9.67] in OSKP). No other within-population diabetic subgroup had significantly higher rates of TB. The only male diabetic group that had a higher rate of TB were RI plus OSKP men aged 50-59 years. Overall, diabetes preceded TB in 87/111 individuals with both diseases (p < 0.0001).


CONCLUSIONS
Our results suggest that T2DM is a predictor for TB in Saskatchewan women aged 20-59 but particularly in RI and OSKP women aged 50-59 years. This has implications for TB screening and prevention initiatives.
Dyck
Roland F
RF
Department of Medicine, University of Saskatchewan, Saskatoon, SK. dyck@sask.usask.ca
Klomp
Helena
H
Marciniuk
Darcy D
DD
Tan
Leonard
L
Stang
Mary Rose
MR
Ward
Heather A
HA
Hoeppner
Vernon H
VH
D000328:Adult; D017677:Age Distribution; D019992:Databases as Topic; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology*; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012525:Saskatchewan / Q000453:epidemiology; D017678:Sex Distribution; D014376:Tuberculosis / Q000150:complications / Q000208:ethnology*