Study objectives: To investigate the characteristics of
tuberculosis infection in diabetic patients at Bellevue Hospital.
Design: We conducted a case-control study retrospectively
reviewing the records of patients at Bellevue Hospital Center from 1987
to 1997 with a discharge diagnosis of tuberculosis and diabetes
Setting: Bellevue Hospital Center is a
1,200-bed, inner-city municipal hospital located in the Lower East Side
of New York City.
Patients: Fifty-three identified
patients had verified tuberculosis infection and diabetes; of these, 50
charts were available for review. One hundred five control cases were
selected from nondiabetic patients with a discharge diagnosis of
tuberculosis during the same time period.
results: Thirty-six percent (18 cases) of the patients with
diabetes and tuberculosis had multidrug-resistant tuberculosis (MDR-TB)
compared to only 10% (10 cases) in the control group (p < 0.01)
Controlling for homelessness, HIV status, and directly observed
therapy, the relative risk of MDR-TB was calculated to be 8.6
(confidence interval, 3.1 to 23.6) in the diabetic group compared to
the control group.
Conclusions: There was a
significant association between diabetes and MDR-TB. Diabetes continues
to be a risk factor for tuberculosis and was associated with MDR-TB in