Latent Tuberculosis Infection Risk Rises in Diabetes
LATENT tuberculosis infection was common in type 2 diabetes, with poor glycemic control linked to higher risk.
Latent tuberculosis infection was identified in 63.7% of adults with type 2 diabetes in a hospital based multicenter cross-sectional study, highlighting a substantial burden of infection in this population. The analysis included 1,363 participants with type 2 diabetes and no prior history of tuberculosis, after exclusion of 16 individuals found to have active disease.
Latent Tuberculosis Infection in Type 2 Diabetes
Participants were recruited from three tertiary hospitals and underwent interferon gamma release assay testing to assess latent tuberculosis infection. The investigators found no notable differences in most socio demographic characteristics between those with and without latent tuberculosis infection. However, several factors emerged as significantly associated with IGRA positivity.
Higher educational attainment, living with a relative with tuberculosis, HbA1c above 7%, and hemoglobin above 14 g/dL were all linked to greater odds of latent tuberculosis infection. In multivariable analysis, these factors remained important, suggesting that both exposure history and metabolic status may contribute to infection risk in adults with type 2 diabetes.
Glycemic Control and Exposure History Stand Out
The study places particular emphasis on glycemic control. Individuals with HbA1c above 7% had a higher likelihood of latent tuberculosis infection, supporting the idea that inadequate glucose control may influence host immune responses relevant to mycobacterial infection. When HbA1c was further stratified, the relationship with latent tuberculosis infection appeared nonlinear, with the 7.0–7.9% range showing increased odds, while trend testing did not demonstrate a consistent linear association across all categories.
Living with a relative affected by tuberculosis also remained a significant risk factor, reinforcing the importance of household exposure when assessing latent tuberculosis infection risk in patients with type 2 diabetes.
Interpreting the Findings
The authors noted that the associations with higher education and elevated hemoglobin should be interpreted cautiously. These factors may reflect underlying socioeconomic, behavioral, or contextual influences rather than direct biological mechanisms. The cross-sectional design also limits causal interpretation.
Even so, the findings suggest that latent tuberculosis infection may be highly prevalent among adults with type 2 diabetes, particularly those with poorer glycemic control or known household exposure. The authors conclude that prospective studies are needed to clarify the temporal relationship between type 2 diabetes and latent tuberculosis infection, and to better define which patients may benefit most from targeted screening strategies.
Reference
Liu Z et al. Analysis of risk factors for latent tuberculosis infection among type 2 diabetics: a hospital-based multicenter cross-sectional study. Frontiers in Cellular and Infection Microbiology. 2026;16:1692527. DOI:10.3389/fcimb.2026.1692527.
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