Diabetic Control and Risk of Tuberculosis: A Cohort Study

Leung, Chi Chiu; Lam, Tai Hing; Chan, Wai Man; Yew, Wing Wai; Ho, Kin Sang; Leung, Gabriel M.; Law, Wing Sze; Tam, Cheuk Ming; Chan, Chi Kuen; Chang, Kwok Chiu

doi:10.1093/aje/kwn075

Cited by 226 publications

(233 citation statements)

References 28 publications

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“…21 A study done by Bokam etal which showed the mean age of the patients pulmonary TB-DM as 52.13 + 10. 20 Compared to previous studies, our study also shows higher mean age i.e. 50 ± 9 years with mean A1c of 8.50±0.03.…”

Section: Sputumcontrasting

confidence: 67%

“…19 Another study done by Bokam etal reported prevalence of 44% of DM among pulmonary TB patients. 20 Compared to previous studies, our study also showed high prevalence (35.7%) of DM among pulmonary TB patients. This explains the increasing prevalence of DM in developing countries like India.…”

Section: Sputumcontrasting

confidence: 57%

“…19 Another study done by Bokam et al, which showed most of the patients (93.2%) presented with cough as a common symptom with mean A1c of 9.02 followed by dyspnea and fever, but there is no relation of A1c on clinical symptoms. 20 A few other studies have shown that the clinical characteristics of TB do not differ among diabetic and non-diabetic patients. [24][25] In our study, all of the patients (100%) were presented with cough as a common symptom with mean A1c of 8.47 ± 0.03 followed by fever (94.6%) with mean A1c of 8.44 ± 0.05, breathlessness (73.4%) with mean A1c of 8.51 ± 0.12, loss of appetite (68%) with mean A1c of 8.18 ± 0.04, weight loss (24.4%) with mean A1c of 8.55 ±0.06 and hemoptysis (26.5%) with mean A1c of 9.12 ±0.23.…”

Section: Sputummentioning

confidence: 96%

“…22 A study done by Bokam et al showed that 59% had involvement of only lower lung fields, 29.5% upper lung fields and 11.3% had involvement of both upper and lower lung fields. 20 Another study done by Avuthu etal showed that patients with poor glycemic control are likely to have lower lung field involvement and cavitary disease on chest radiograph. 7 In this study as per the radiographic presentation (observed by a Radiologist), out of 94 patients majority had only lower lung field involvement -71 (75.5%) with mean A1c of 8.61±0.094; 12 patients (12.7%) had only upper lung field involvement with mean A1c of 7.53 ± 0.012 and 9 patients (9.5%) had involvement of both lung fields with mean A1c of 9.19±0.082.…”

Section: Sputummentioning

confidence: 98%

“…A study done by Bokam etal, which showed people with very poor glycemic control had high sputum positivity rates with mean A1c of 9.46, while A1c of 8 in case of sputum negative patients. 20 With regard to the rate of positive smears at the time of diagnosis, results are conflicting. Although, some authors reported a higher frequency of negative sputum smears among TB-DM cases, 26 others found DM as an independent risk factor for numerous acid-fast bacilli on the sputum smear examination 24 and some showed no association between DM and patient's bacteriology results.…”

Section: Sputummentioning

confidence: 99%

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An Observational Study to Determine the Impact of Glycaemic Control on Presentation of Drug Sensitive and Drug Resistant Pulmonary Tb in Type 2 Diabetes

Mahmood¹,

Verma²,

Ahmad³

et al. 2018

jemds

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BACKGROUND There is a strong correlation between the two diseases, diabetes and tuberculosis, with impact of one on the other. Poor glycaemic control causes poor outcome of tuberculosis treatment and that can be observed radiologically and microbiologically beside clinical observation.The aim of the study is to study the impact of glycemic control on presentation (clinical, radiological and microbiological) of drug sensitive and drug resistant pulmonary TB in type 2 diabetes. MATERIALS AND METHODSThis is an observational cross-sectional study. Patients above 18 years, having PTB with DM over one year were included. PTB with other conditions like HIV, Pregnancy, Connective tissue disorders, Chronic renal failure, Chronic liver disease, Malignancy, on longterm steroid use or cytotoxic drug therapy or on immunosuppressive drugs were not included in this study. Glycemic control was assessed by A1c < 7 as controlled and > 7 as uncontrolled. Clinical, Microbiological and Radiographic parameters of the patients were studied in respect to their glycemic control. RESULTS263 PTB patients who were screened for the study, out of which 94 were diabetic. The prevalence of D Min PTB patients was found to be 35.7% (out of 180 drug-sensitive PTB patients 68 were diabetic and out of 83 drug resistant PTB patients 26 were diabetic). The overall mean age was (50 ± 9) years, maximum no. of patients (60%) were in 40 -60 years' age group, 70% males with mean A1c (8.54 ± 0.03), 81% had uncontrolled glycemic status and 100% had cough with mean A1c (8.47 ± 0.03). 81% were sputum AFB positive with mean A1c (8.64 ± 0.014), 75.5% had lower lung field abnormalities with mean A1c (8.61 ± 0.094), 12.57% upper lung field with mean A1c (7.53 ± 0.012), 9.5% both lung fields with mean A1c (9.19 ± 0.082), 84% had infiltrative lesions with mean A1c (8.45 ± 0.017) and 25.5% had cavities with high mean A1c (10.04 ± 0.029). CONCLUSIONThe association between DM and TB is the most emerging challenge for global TB control. Poor glycemic control has significant effect on sputum smear positivity, more cavity formation and lower lung field involvement with no effect on clinical symptom. Hence, with the help of this study, it can be concluded that screening for DM should be performed routinely in patients with TB that may improve treatment outcomes. Submission 30-12-2017, Peer Review 27-01-2018, Acceptance 01-02-2018, Published 12-02-2018. Corresponding Author: Dr. Tariq Mahmood, Professor and HOD, Department of Pulmonary Medicine, MLN Medical College, Allahabad-211001, Uttar Pradesh, India. E-mail: mlnmctariqmahmood@gmail.com DOI: 10.14260/jemds/2018 An estimated 10.4 million people fell ill with TB in 2016: 90% were adults, 65% were male, 10% were people living with HIV (74% in Africa) and 56% were in five countries: India, Indonesia, China, the Philippines and Pakistan. Drugresistant TB is a continuing threat to world community. In 2016, there were 6 lakh new cases with resistance to rifampicin, the most effective first-line drug, of whi...

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Section: Sputumcontrasting

confidence: 67%

Section: Sputumcontrasting

confidence: 57%

Section: Sputummentioning

confidence: 96%

Section: Sputummentioning

confidence: 98%

Section: Sputummentioning

confidence: 99%

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An Observational Study to Determine the Impact of Glycaemic Control on Presentation of Drug Sensitive and Drug Resistant Pulmonary Tb in Type 2 Diabetes

Mahmood¹,

Verma²,

Ahmad³

et al. 2018

jemds

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Diabetes in Asia

Chan

Malik²,

Jia³

et al. 2009

JAMA

1,685

675

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Background Diabetic foot ulcer infection cause great morbidity and mortality among diabetic patients and is a major cause of lower extremity amputation worldwide. This study aimed to determine the profile of aerobic bacteria and their antibiotic sensitivity patterns in diabetic foot infections (DFI) among different Wagner's grades. Methods This study was conducted during December 2017-March 2018 in a Diabetic Center, Sudan. A total of 152 diabetic patients with different grades of foot ulcers were randomly enrolled in the study. The patients were grouped using Wagner's classification. Tissue biopsies and deep swabs were collected from the ulcers for aerobic cultures. The cultured isolates were identified using phenotypic and biochemical properties and their sensitivity to commonly used antibiotics, Colistin, Aikacin, Ciprofloxacin, Augmentin, Ceftazideme, Gentamicin, Clindamycin, Ceftriaxone Meropenum. Cotrimoxazole, Erythomycin, Oxacillin and Vancomycin. Fusidic acid, Imepenem, and Piperacillin was tested using the Kirby Bauer disk diffusion method. Results The mean age of the patients was 54.31 (SD ± 12.1) years, male to female ratio of 8: 1. The mean duration of diabetes was 14 (SD ± 8) years. The ulcers varied in duration from 1 day to 10 years. of 152 samples 181 aerobic bacteria were isolated. Cultures yielded 1-3 isolate per culture. The maximum number was isolated from grade 3 group followed by long standing ulcer LSU group 50.8% and 28% respectively. Polymicrobial infection was higher in LSU (30.4%). The isolates were mostly Gram-negative bacteria. The most frequent were proteus spp. (35.3%), S. aureus MRSA 14.4% and Coliform 12.2% respectively. The most common isolates in grade 3 were P. Mirablis, Staphylococcus and Coliform and in long standing ulcers were P. Mirablis, S. aureus MRSA and Coagulase negative staphylococcus respectively. Conclusion Gram-negative bacteria were more prevalent and the most frequent pathogens were Proteus spp. The

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Diabetes Status and Association With Risk of Tuberculosis Among Korean Adults

et al. 2021

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Key Points Question Is the risk of developing tuberculosis (TB) associated with diabetes duration or fasting plasma glucose (FPG) levels? Findings In this population-based cohort study, longer duration of diabetes was associated with the development of TB, showing a dose-response association. TB was more common among participants with FPG levels greater than or equal to 202 mg/dL. Meaning These findings suggest that for TB prevention, FPG control should be reinforced even in patients with new-onset diabetes.

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Diabetic Control and Risk of Tuberculosis: A Cohort Study

Cited by 226 publications

References 28 publications

An Observational Study to Determine the Impact of Glycaemic Control on Presentation of Drug Sensitive and Drug Resistant Pulmonary Tb in Type 2 Diabetes

An Observational Study to Determine the Impact of Glycaemic Control on Presentation of Drug Sensitive and Drug Resistant Pulmonary Tb in Type 2 Diabetes

Diabetes in Asia

Diabetes Status and Association With Risk of Tuberculosis Among Korean Adults

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