Taken together, studies show that diabetes increases risk of tuberculosis
People with diabetes mellitus are at increased risk of developing active tuberculosis (TB), according to an analysis published in PLoS Medicine.
Searching for research over the past four decades containing data on the relationship between diabetes and TB, Christie Jeon and Megan Murray of the Harvard School of Public Health identified 13 studies involving more than 1.7 million participants, including 17,698 cases of TB. Combining the data from cohort studies in particular, the researchers calculated that diabetes increases the risk of active TB by about a factor of three.
A three-fold increased risk suggests that diabetes may already be responsible for more than 10% of TB cases in India and China. If these findings are replicated in other countries, global TB control might benefit from special attention to people with diabetes when identifying and treating latent TB. Increased efforts to diagnose and treat diabetes might also decrease the global burden of TB, which kills about 1.6 million people each year.
Citation: Jeon CY, Murray MB (2008) Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med 5(7): e152. doi:10.1371/journal.pmed.0050152.
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ALSO PUBLISHED THIS WEEK IN THE PLoS MEDICINE MAGAZINE SECTION
PLoS Medicine editors applaud new law on accessibility of clinical trials results
An editorial published this week in PLoS Medicine hails the US FDA Amendments Act of 2007 as a major step towards open access to results of all clinical trials. The new law, which takes effect in September 2008, will require researchers and trial sponsors to post the results of clinical trials on a publicly accessible Internet site, whether or not the results have been published in a journal. However, the law is only relevant to studies which fall under the FDA's mandate, therefore it mainly applies to trials done in order to gain regulatory approval for drugs or devices in the US. Phase 1 trials and many device trials are also excluded from the new legislation.
The editorial highlights important initiatives in the first half of 2008 by high-profile research organizations in Canada, Europe and the USA in support of open access repositories and comments that "the new law is innovative in bridging the gap between a clinical trial's registration at inception (now an established requirement for publication) and the public archiving of its final peer-reviewed report".
While the editors at PLoS Medicine anticipate challenges ahead, including how to maintain the integrity of data and interpretations posted without traditional peer review, they urge other journals to support public access to clinical trials results. They also urge journals to partake in "an international dialogue of constituencies interested in results reporting" with the goal of "contributing toward the development of international standards for results disclosure" as advocated by the PROCTOR group (Public Reporting of Clinical Trials Outcomes and Results) convened by the Canadian Institutes of Health Research.
Citation: The PLoS Medicine Editors (2008) Next stop, don't block the doors: Opening up access to clinical trials results. PLoS Med 5(7): e160. doi:10.1371/journal.pmed.0050160
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PLoS Medicine Editors
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