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The Relationship Between Diabetes and Tuberculosis in Saskatchewan

Comparison of Registered Indians and Other Saskatchewan People

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Abstract

Background

Saskatchewan Aboriginal people are experiencing epidemics of both type 2 diabetes (T2DM) and tuberculosis (TB). The purpose of this study was to determine if a relationship exists between diabetes and TB in Saskatchewan and to establish whether there is a difference in the degree of any association between Aboriginal and non- Aboriginal people.

Methods

Utilizing Saskatchewan Health databases, TB incidence (cases identified from 1986–2001) was compared between four subpopulations identified from 1991–1995: Registered Indians (RI) with and without diabetes, and other Saskatchewan people (OSKP) with and without diabetes.

Results

Diabetic women aged 20–59 years had higher average annual incidence rates of TB than non-diabetic women, but within-population rate ratios of TB in diabetic versus non-diabetic women were only significant in those aged 50–59 (2.7 [CI 1.28, 5.72] in RI and 3.9 [CI 1.58, 9.67] in OSKP). No other within-population diabetic subgroup had significantly higher rates of TB. The only male diabetic group that had a higher rate of TB were RI plus OSKP men aged 50–59 years. Overall, diabetes preceded TB in 87/111 individuals with both diseases (p<0.0001).

Conclusions

Our results suggest that T2DM is a predictor for TB in Saskatchewan women aged 20–59 but particularly in RI and OSKP women aged 50–59 years. This has implications for TB screening and prevention initiatives.

Résumé

Contexte

Les Autochtones de la Saskatchewan sont aux prises avec des épidémies de diabète de type II et de tuberculose. Dans cette étude, nous avons voulu déterminer s’il existe un lien entre le diabète et la tuberculose en Saskatchewan, et s’il y a une différence entre les Autochtones et les non-Autochtones en ce qui a trait au degré d’association éventuel entre ces maladies.

Méthode

À l’aide des bases de données du ministère de la Santé de la Saskatchewan, nous avons comparé la fréquence de la tuberculose (les cas détectés de 1986 à 2001) dans quatre souspopulations définies pour la période de 1991 à 1995: les Indiens inscrits, diabétiques et non diabétiques, et les autres habitants de la Saskatchewan (AHSK), diabétiques et non diabétiques.

Résultats

Chez les femmes diabétiques de 20 à 59 ans, le taux d’incidence annuel moyen de la tuberculose était plus élevé que chez les femmes non diabétiques, mais les ratios des taux de tuberculose entre les femmes diabétiques et non diabétiques dans chaque population n’étaient significatifs que pour les femmes de 50 à 59 ans (IC de 2,7 [1,28 à 5,72] chez les Indiennes inscrites et de 3,9 [1,58 à 9,67] chez les AHSK). Aucun autre sous-groupe de diabétiques à l’intérieur d’une population n’avait de taux sensiblement plus élevés de tuberculose. Le seul groupe d’hommes diabétiques dont le taux de tuberculose était plus élevé se composait d’Indiens inscrits et d’AHSK âgés de 50 à 59 ans. Globalement, le diabète avait précédé la tuberculose chez 87 des 111 sujets ayant les deux maladies (p<0,0001).

Conclusions

Nos résultats donnent à penser que le diabète de type II est un prédicteur de la tuberculose chez les femmes de la Saskatchewan de 20 à 59 ans, mais plus particulièrement chez les Indiennes inscrites et les autres habitantes de la Saskatchewan âgées de 50 à 59 ans. Ceci aurait des conséquences pour le dépistage et les mesures de prévention de la tuberculose.

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Authors and Affiliations

  1. Department of Medicine, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada

    Roland F. Dyck MD, Helena Klomp RN, MSc, Darcy D. Marciniuk MD, Heather A. Ward MD & Vernon H. Hoeppner MD

  2. Department of Community Health and Epidemiology, University of Saskatchewan, Canada

    Roland F. Dyck MD & Leonard Tan MB, PhD

  3. Population Health Branch, Saskatchewan Department of Health, Regina, Canada

    Mary Rose Stang PhD

Authors
  1. Roland F. Dyck MD
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  2. Helena Klomp RN, MSc
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  3. Darcy D. Marciniuk MD
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  4. Leonard Tan MB, PhD
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  5. Mary Rose Stang PhD
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  6. Heather A. Ward MD
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  7. Vernon H. Hoeppner MD
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Corresponding author

Correspondence to Roland F. Dyck MD.

Additional information

Disclaimer: This study is based in part on non-identifiable data provided by the Saskatchewan Department of Health. The interpretations and conclusions contained herein do not necessarily represent those of the Government of Saskatchewan or the Saskatchewan Department of Health.

Funding: Supported by a grant from the Saskatchewan Health Research Foundation.

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Dyck, R.F., Klomp, H., Marciniuk, D.D. et al. The Relationship Between Diabetes and Tuberculosis in Saskatchewan. Can J Public Health 98, 55–59 (2007). https://doi.org/10.1007/BF03405386

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  • DOI: https://doi.org/10.1007/BF03405386

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