Adults with type 2 diabetes have a significantly higher prevalence of latent tuberculosis infection (LTBI) compared to the general population, according to medical research. LTBI is a state where the tuberculosis bacteria live in the body without causing active illness, but it carries a risk of progressing to active TB disease later.
A 2023 systematic review and meta-analysis published in BMJ Open found the global prevalence of LTBI among people with type 2 diabetes was approximately 25%. However, this rate can be substantially higher in regions with a high overall burden of TB. Poor glycemic control is a key factor, with studies indicating that individuals with higher HbA1c levels (a measure of long-term blood sugar) are at greater risk.
The biological link involves a compromised immune system. Diabetes, particularly when uncontrolled, can impair the function of immune cells like macrophages and T-cells, which are crucial for containing the TB bacteria. This immune dysfunction makes it harder for the body to control the initial infection, allowing it to establish a latent state.
Public health experts emphasize the importance of screening for LTBI in diabetic populations, especially in high-TB-burden countries. Identifying and treating LTBI with preventive therapy is a critical strategy to reduce the future risk of active TB, which is contagious and more severe in individuals with diabetes.
