Factors associated with diabetes mellitus among adults with tuberculosis in a large European city, 2000-2013

BACKGROUND: Diabetes mellitus (DM) can contribute to the development of tuberculosis (TB). OBJECTIVE: To analyse the prevalence of DM and its associated factors among adults with TB in a large city in an industrialised country. METHODS: This is a population-based study in adults diagnosed with TB between 2000 and 2013 in Barcelona. We studied potentially associated sociodemographic and clinical/epidemiological factors. Logistic regression was used to calculate odds ratios (ORs) and their 95% confidence intervals (CIs). RESULTS: Of 5849 TB patients, 349 (5.9%) had DM. The annual prevalence of DM ranged from 4.0% to 7.2%. Factors associated with DM were being Spanish-born (OR 1.46, 95%CI 1.11-1.96), age >= 40 years (OR 6.08, 95%CI 4.36-8.66), cavitary patterns on chest X-ray (OR 1.42, 95%CI 1.08-1.86), experiencing more side effects due to anti-tuberculosis treatment (OR 1.86, 95%CI 1.28-2.64) and hospitalisation at the time of diagnosis (OR 1.8, 95%CI 1.40-2.31). Human immunodeficiency virus infection was associated with a lower probability of DM in both subjects with a history of injection drug use (OR 0.27, 95%CI 0.10-0.57) and those without (OR 0.04, 95%CI 0.002-0.19). CONCLUSIONS: DM prevalence among adults with TB in Barcelona is low and remained stable over the 14-year study period. However, TB patients with DM were potentially more infectious and their clinical management was more complicated.