title: Association between diabetes mellitus and tuberculosis in United States-born and foreign-born populations in San Francisco.
abstract: METHODS
  The impact of diabetes on tuberculosis in United States and foreign-born populations in San Francisco has not been studied.
  
  
  OBJECTIVE
  To determine the characteristics, prevalence and temporal trends of diabetes in US and foreign-born persons attending the San Francisco Tuberculosis Clinic.
  
  
  METHODS
  We analyzed data from individuals seeking medical attention at the San Francisco Tuberculosis Clinic. We included patients with diagnosis of tuberculosis, latent infection, or not infected with Mycobacterium tuberculosis. We assessed the temporal trend and the characteristics of individuals with and without diabetes.
  
  
  RESULTS
  Between 2005 and 2012, there were 4371 (19.0%) individuals without evidence of tuberculosis infection, 17,856 (77.6%) with latent tuberculosis, and 791 (3.4%) with tuberculosis. 66% were born in the United States, China, Mexico, and the Philippines. The prevalence of diabetes was the highest among individuals with tuberculosis and increased during the study period. Patients with tuberculosis and diabetes were more likely to be male, older than 45 years and born in the Philippines. There was a disproportionate association of TB and DM relative to LTBI and DM among Filipinos in individuals older than 45 years old.
  
  
  CONCLUSIONS
  Our data suggest that Filipinos older than 45 years old are more likely to have tuberculosis probably due to a higher prevalence of diabetes. In San Francisco, tuberculosis-screening programs in individuals with diabetes and latent tuberculosis may be beneficial in patients older than 45 years old especially from the Philippines.
authors.affiliation: Curry International Tuberculosis Center, University of California San Francisco, San Francisco, California, United States of America; Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Gompol
authors.initials: G
authors.lastname: Suwanpimolkul
authors.affiliation: Tuberculosis Control, San Francisco Department of Public Health, San Francisco, California, United States of America.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Grinsdale
authors.affiliation: Curry International Tuberculosis Center, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Leah G
authors.initials: LG
authors.lastname: Jarlsberg
authors.affiliation: Tuberculosis Control, San Francisco Department of Public Health, San Francisco, California, United States of America.
authors.forename: Julie
authors.initials: J
authors.lastname: Higashi
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Osmond
authors.affiliation: Curry International Tuberculosis Center, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Hopewell
authors.affiliation: Curry International Tuberculosis Center, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Midori
authors.initials: M
authors.lastname: Kato-Maeda
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology*; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012495:San Francisco / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*