The effect of diabetes and prediabetes on antituberculosis treatment outcomes

The proportion of individuals with dysglycemia (DM or pre-DM) did not significantly differ between those with favorable and unfavorable outcomes. However, dysglycemia was more frequent in TB patients who experienced treatment failure (P = .02) or death (P = .045). Individuals with favorable outcomes had lower HbA1c levels compared to those with treatment modification (P = .016), failure (P = .002), or death (P = .047). Among those with unfavorable outcomes, patients with treatment modification had lower HbA1c levels than those with treatment failure (P < .001) or who died (P = .012). Weight loss was more common in individuals with DM than in those with pre-DM or normoglycemia (P < .001). A higher proportion of TB patients with dysglycemia had a positive smear at baseline compared to those with normoglycemia. DM, but not pre-DM or dysglycemia overall, was independently associated with unfavorable TB treatment outcomes. HbA1c values were also independently linked to unfavorable outcomes.

[TB0069] Arriaga, M.B., Araújo-Pereira, M., Barreto-Duarte, B., Nogueira, B., Freire, M.V.C., Queiroz, A.T., Rodrigues, M.M., Rocha, M.S., Souza, A.B., Spener-Gomes, R. and Carvalho, A.C.C., 2022. The effect of diabetes and prediabetes on antituberculosis treatment outcomes: a multicenter prospective cohort study. The Journal of Infectious Diseases, 225(4), pp.617-626.

Related study:

Chang, J.T., Dou, H.Y., Yen, C.L., Wu, Y.H., Huang, R.M., Lin, H.J., Su, I.J. and Shieh, C.C., 2011. Effect of type 2 diabetes mellitus on the clinical severity and treatment outcome in patients with pulmonary tuberculosis: a potential role in the emergence of multidrug-resistance. Journal of the Formosan Medical Association, 110(6), pp.372-381.

  • DMTB (Diabetes Mellitus with Tuberculosis) patients required significantly longer treatment for cure, completion, and sputum conversion.
  • Compromised immune function due to diabetes contributes to more severe infections, higher mycobacterial loads, higher treatment failure rates, and delayed mycobacterial clearance in DMTB patients.
  • DMTB patients had a higher percentage of MDR-TB (Multi-Drug Resistant Tuberculosis) and were more likely to develop MDR-TB than TB-only patients.
  • Pulmonary TB patients with type 2 diabetes may need a more intensive anti-TB regimen and careful follow-up for MDR-TB.

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