title: Diabetes as an increasingly common comorbidity among patient hospitalizations for tuberculosis in the USA.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Internal Medicine , University of Iowa , Iowa City, Iowa , USA.
authors.forename: Roula S
authors.initials: RS
authors.lastname: Zahr
authors.affiliation: Department of Biostatistics , University of Iowa , Iowa City, Iowa , USA.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Peterson
authors.affiliation: Department of Pharmacy Practice and Science , University of Iowa , Iowa City, Iowa , USA.
authors.forename: Linnea A
authors.initials: LA
authors.lastname: Polgreen
authors.affiliation: Department of Biostatistics , University of Iowa , Iowa City, Iowa , USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Cavanaugh
authors.affiliation: Department of Internal Medicine , University of Iowa , Iowa City, Iowa , USA.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Hornick
authors.affiliation: Department of Infectious Diseases, Ophthalmology, Public Health and Preventive Medicine , Oregon Health and Science University , Portland, Oregon , USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Winthrop
authors.affiliation: Departments of Internal Medicine and Epidemiology , University of Iowa , Iowa City, Iowa , USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Polgreen
keywords: Epidemiology; Glycemic Control; Tuberculosis