title: Diabetes, glycemic control, and risk of tuberculosis: a population-based case-control study.
abstract: OBJECTIVE
  To examine the association between diabetes, glycemic control, and risk of tuberculosis (TB).
  
  
  METHODS
  We conducted a population-based case-control study in Northern Denmark. Cases of active TB were all individuals with a first-time principal hospital diagnosis of TB between 1980 and 2008. Each case subject was matched with up to five population control subjects with similar age, sex, place and length of residence in Denmark, and country of emigration. We computed odds ratios (ORs) for a first-time TB diagnosis among people with and without diabetes using regression to control for other comorbidities, alcoholism, immunosuppressive medications, and socioeconomic markers.
  
  
  RESULTS
  We identified 2,950 patients, including 156 diabetic individuals (5.3%), with active TB, and 14,274 population control subjects, of which 539 had diabetes (3.8%). The adjusted OR for active TB among subjects with diabetes was 1.18 (95% CI 0.96-1.45) compared with nondiabetic individuals. We found a similar risk increase from diabetes in the 843 (29%) TB case subjects who were immigrants; adjusted OR = 1.23 (95% CI 0.78-1.93). In a subset with laboratory data, diabetic individuals with an HbA(1c) <7.0, 7-7.9, and ≥8.0% had ORs of 0.91 (0.51-1.63), 1.05 (0.41-2.66), and 1.19 (CI 0.61-2.30), respectively, compared with individuals without diabetes.
  
  
  CONCLUSIONS
  In the low TB-burden country of Denmark, the TB risk increase associated with diabetes is substantially lower than previously suggested. We found no evidence for any association between TB and dysglycemia.
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Leegaard
authors.forename: Anders
authors.initials: A
authors.lastname: Riis
authors.forename: Jette B
authors.initials: JB
authors.lastname: Kornum
authors.forename: Julie B
authors.initials: JB
authors.lastname: Prahl
authors.forename: Vibeke Ø
authors.initials: VØ
authors.lastname: Thomsen
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
authors.forename: C Robert
authors.initials: CR
authors.lastname: Horsburgh
authors.forename: Reimar W
authors.initials: RW
authors.lastname: Thomsen
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D048909:Diabetes Complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D014376:Tuberculosis / Q000150:complications* / Q000453:epidemiology
chemical_list: D001786:Blood Glucose