The Influence of DM, Glycemic Control, and Diabetes-Related Comorbidities on Pulmonary TB

Chiang CY, Bai KJ, Lin HH, Chien ST, Lee JJ, Enarson DA, et al. (2015) The Influence of Diabetes, Glycemic Control, and Diabetes-Related Comorbidities on Pulmonary Tuberculosis. PLoS ONE 10(3): e0121698. doi:10.1371/journal. pone.0121698.

Summary:

  1. Study Overview and Patient Demographics: Data were collected from three teaching hospitals across Taiwan, examining culture-positive pulmonary TB patients registered from 2005–2010. The study involved 1,473 patients (705 with diabetes, 768 without) who initiated treatment within three months of sputum collection.

  2. Exclusion Criteria: Patients with transient hyperglycemia at the start of anti-TB treatment were excluded.

  3. TB Treatment Outcomes: Outcomes were classified as successful, failed, lost-to-follow-up, or death. Diabetic patients were less likely to achieve treatment success and had higher risks of death and being lost-to-follow-up.

  4. Symptoms and Associations with Diabetes: Diabetic patients exhibited a higher prevalence of symptoms such as cough, hemoptysis, tiredness, and weight loss. The severity of symptoms correlated with higher HbA1C levels, particularly evident in patients with HbA1C over 9%.

  5. Statistical Findings: Multivariate logistic regression showed that diabetes significantly increased the likelihood of displaying TB symptoms and maintaining a positive smear, which were influenced by HbA1C levels. Other significant factors included sex, age, smoking, and drug resistance.

  6. Impact of Diabetes on TB Treatment: The study highlighted the role of diabetes and diabetes-related comorbidities in influencing TB treatment outcomes. Effective glycemic control was emphasized as a crucial factor in improving treatment outcomes and reducing TB transmission risks. 

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