Association of Pulmonary Tuberculosis and Diabetes in Mexico: Analysis of the National Tuberculosis Registry 2000-2012.

BACKGROUND: Tuberculosis (TB) remains a public health problem in Mexico while the incidence of diabetes mellitus type 2 (DM) has increased rapidly in recent years. OBJECTIVE: To describe the trends of incidence rates of pulmonary TB associated with DM and not associated with DM and to compare the results of treatment outcomes in patients with and without DM. MATERIALS AND METHODS: We analysed the National Tuberculosis Registry from 2000 to 2012 including patients with pulmonary TB among individuals older than 20 years of age. The association between DM and treatment failure was analysed using logistic regression, accounting for clustering due to regional distribution. RESULTS: In Mexico from 2000 to 2012, the incidence rates of pulmonary TB associated to DM increased by 82.64%, (p<0.001) in contrast to rates of pulmonary TB rate without DM, which decreased by 26.77%, (p<0.001). Patients with a prior diagnosis of DM had a greater likelihood of failing treatment (adjusted odds ratio, 1.34 (1.11-1.61) p<0.002) compared with patients who did not have DM. There was statistical evidence of interaction between DM and sex. The odds of treatment failure were increased in both sexes. CONCLUSION: Our data suggest that the growing DM epidemic has an impact on the rates of pulmonary TB. In addition, patients who suffer from both diseases have a greater probability of treatment failure.

Un nuevo paradigma para la época de la prevención de la diabetes / A new paradigm for diabetes prevention era

La definición de la diabetes ha cambiado sucesivamente a lo largo de su historia de más de 3 000 años, a medida que la ciencia ha proporcionado nuevos datos sobre la patogenia de sus manifestaciones clínicas. Esta revisión analiza el origen y la evolución subsiguiente de las sucesivas definiciones de la diabetes mellitus a la luz de la información proporcionada por las ciencias médicas, y pretende estimular el análisis crítico de los enfoques vigentes, para ayudar a desarrollar nuevos paradigmas acordes con los nuevos retos que plantea la creciente epidemia de obesidad y de diabetes que sufre la humanidad actualmente..(AU)

Definition of term diabetes has change successively during more than 3 000 years of its history just as science has provides new data on pathogeny of its clinical manifestations. The present review analyze the origin and the subsequent course of successive definitions of diabetes mellitus in the light of the information offered by the medical sciences and to promote the critical analysis of the prevailing approaches to help in development of new paradigms in keeping with the new challenges for the increasing obesity and diabetes epidemic suffering by humanity at present times...(AU)

The E23K variant in the Kir6.2 subunit of the ATP-sensitive K+ channel does not augment impaired glucose tolerance in Caribbean subjects with a family history of type 2 diabetes

The E23K variant of the Kir6.2 gene has been shown to be associated with type 2 diabetes mellitus in Caucasian subjects. Because offspring of type 2 diabetic patients have a genetically increased risk of developing diabetes, we sought to identify the E23K variant of the Kir6.2 gene in offspring of Caribbean patients with type 2 diabetes and assess the contribution of this variant to impaired glucose tolerance in these subjects. Forty-six offspring of patients with type 2 diabetes and 39 apparently healthy subjects whose immediate parents were not diabetic (‘control’) were studied after an overnight fast. Anthropometric indices were measured and blood samples were collected. Fasting and 2 h plasma glucose, insulin and lipids were subsequently determined. Insulin resistance was calculated using the homeostatic model assessment technique. The offspring and control subjects had similar frequencies of the E23K polymorphism (52.6 vs 45.5 per cent, P>0.05) and the frequency of the E23K variant did not differ significantly between gender and ethnic distributions, irrespectively of a family history of diabetes (P>0.05). There were no significant differences in biochemical risk factors for developing diabetes in offspring carriers of the E23K variant compared with offspring non-carriers of the mutation. Offspring with the E23K mutation had even significantly higher 2 h insulin concentrations when compared with control subjects. It is concluded that the presence of the Kir6.2 E23K genotype in Caribbean subjects with an immediate positive family history of diabetes does not confer significantly higher levels of biochemical risk factors for the development of type 2 diabetes.