DM affects the treatment outcomes of drug-resistant tuberculosis

A systematic review and meta-analysis were conducted, involving twenty-five studies that ranged from cohort to case-control and cross-sectional designs, published between 2005 and 2022. Geographically, the studies were predominantly from Asia, with twenty studies focusing on Asian populations, followed by four from Europe, three from Africa, and one from America.[1]

The total number of participants in these studies was 16,905, all diagnosed with DR-TB. Of these, 59.89% (10,124 patients) had MDR-TB, and 11.54% (1,952 patients) were also diabetic (DM+). This analysis highlights a significant association between DM and poorer treatment outcomes in DR/MDR-TB.[1]

Patients with diabetes mellitus (DM) were found to have a higher likelihood of unsuccessful treatment outcomes in both drug-resistant tuberculosis (DR-TB) and multidrug-resistant tuberculosis (MDR-TB). Specifically, the odds ratio (OR) for unsuccessful outcomes was 1.56 (95% CI: 1.24–1.96) for DR-TB and 1.57 (95% CI: 1.20–2.04) for MDR-TB. Regarding mortality, the pooled OR for death was not significantly different between DM and non-DM patients, with ORs of 1.32 (95% CI: 0.97–1.82) for DR-TB and 1.33 (95% CI: 0.85–2.07) for MDR-TB.[1]

In terms of positive outcomes, patients without DM were more likely to be cured (DR-TB: OR = 0.64, 95% CI: 0.44–0.94; MDR-TB: OR = 0.55, 95% CI: 0.35–0.87) and to complete treatment (DR-TB: OR = 0.63, 95% CI: 0.46–0.86; MDR-TB: OR = 0.66, 95% CI: 0.46–0.93). Conversely, DM patients had a higher risk of treatment failure (DR-TB: OR = 1.28, 95% CI: 1.03–1.58; MDR-TB: OR = 1.37, 95% CI: 1.08–1.75).[1]

References:

1. Xu, G., Hu, X., Lian, Y. and Li, X., 2023. Diabetes mellitus affects the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis. BMC Infectious Diseases, 23(1), p.813.