Glycemic Control and the Risk of Tuberculosis

Lee P-H, Fu H, Lai T-C, Chiang C-Y, Chan C-C, Lin H-H (2016) Glycemic Control and the Risk of Tuberculosis: A Cohort Study. PLoS Med 13(8): e1002072. doi:10.1371/journal.pmed.1002072 

  • Diabetes Mellitus (DM) increases the risk of active tuberculosis (TB) and is associated with higher rates of treatment failure, relapse, and mortality in TB patients.
  • A community-based screening service in New Taipei City (2005-2008) followed adults aged 30 years and older until 2012, screening for chronic diseases and cancers.
  • The study classified DM into: no DM, DM with good glycemic control (FPG ≤ 130 mg/dl), and DM with poor glycyclic control (FPG > 130 mg/dl).
  • Of the 122,042 participants with fasting plasma glucose (FPG) data, 11,260 (9.2%) had DM at baseline, and 71.2% of those with DM had poor glycemic control.
  • Incidence rates of TB per 100,000 person-years were: 54.2 for nondiabetic individuals, 65.1 for DM patients with good control, and 155.5 for those with poor control.
  • The Kaplan-Meier analysis showed significantly different TB-free survival by DM status, with the poorest survival in those with poor glycemic control.
  • Multivariable Cox regression analysis revealed that DM patients, particularly those with poor glycemic control, had a higher hazard of developing TB compared to nondiabetic individuals.
  • There was no significant sex or BMI-related effect modification on the association between glycemic control and TB risk.
  • It was estimated that 7.5% of TB cases could have been prevented if all diabetic patients achieved good glycemic control.
  • The study suggests that managing DM effectively could help control TB, advocating for prevention of DM, early detection, proper glycyclic control, and bi-directional screening for DM and TB.

    •  

    Comments

    Post a Comment

    Popular posts from this blog

    Nutritional status in patients with TB and DM

    Patel, D.G., Baral, T., Kurian, S.J., Malakapogu, P., Saravu, K. and Miraj, S.S., 2024. Nutritional status in patients with tuberculosis and diabetes mellitus: A comparative observational study.  Journal of Clinical Tuberculosis and Other Mycobacterial Diseases ,  35 , p.100428. Cardiovascular disease prevalence was highest in the DM group, followed by the TB-DM group. Anaemia was more prevalent in the TB-DM group. Smoking and alcohol use were most common in the TB group, followed by the TB-DM group. See also: TB and kidney function impairment In the TB-DM group, HbA1c levels indicated poor diabetic control (10.47%), higher than in the DM group (8.17%). FBS was also above normal in the TB-DM group, followed by the DM group. Although there were no significant differences in nutritional parameters like albumin, globulin, and total proteins, vitamin B12 levels were highest in the TB-DM group. Notably, 95.83% of patients in the TB-DM group had HbA1c > 6.5, with similarly high FBS and RB
    Read more

    Scientific advances and the end of tuberculosis

    Reid, M., Agbassi, Y.J.P., Arinaminpathy, N., Bercasio, A., Bhargava, A., Bhargava, M., Bloom, A., Cattamanchi, A., Chaisson, R., Chin, D. and Churchyard, G., 2023. Scientific advances and the end of tuberculosis: a report from the Lancet Commission on Tuberculosis.  The Lancet ,  402 (10411), pp.1473-1498. Progress toward ending tuberculosis varies greatly across countries, with some achieving substantial improvements and others making minimal progress. Key challenges include frail health systems, underinvestment, and reliance on one-size-fits-all approaches. Insufficient case finding and diagnosis remain the most significant issues in high-burden countries, where only 38% of all tuberculosis cases were tested with WHO-recommended rapid molecular diagnostics in 2021. Two-thirds of tuberculosis deaths occurred in just eight countries, with over half of these in India, Indonesia, and Nigeria. Despite these challenges, some sub-Saharan African countries have seen improvements in tubercul
    Read more

    Impact of diabetes on tuberculosis and MDRTB susceptibility

    There is a significant association between diabetes mellitus (DM) and multidrug-resistant tuberculosis (MDR-TB). TB patients without DM have a lower risk of developing MDR-TB compared to those with DM. Factors contributing to MDR-TB emergence in TB patients with DM include: Impaired immune function Altered microbial genomics Uncontrolled glucose levels, increasing susceptibility to MDR-TB Compromised phagocytic activity and reduced chemotactic response Increased oxidative species and microbe proliferation Altered drug disposition Higher likelihood of non-adherence to treatment TB patients with DM also experience higher treatment failure rates compared to those without DM. Most information on these associations is based on self-reported data or patient health records, which may introduce assessment errors Rehman Au, Khattak M, Mushtaq U, Latif M, Ahmad I, Rasool MF, Shakeel S, Hayat K, Hussain R, Alhazmi GA, Alshomrani AO, Alalawi MI, Alghamdi S, Imam MT, Almarzoky Abuhussain SS, Khayya
    Read more