Effect of Anti-tubercular Drugs and Impact of Glycemic Status in Patients with Tuberculosis and Concomitant Diabetic- Tuberculosis Patients

Abstract

India is a key nation which is endemic and epidemic to tuberculosis and diabetes. An association between diabetes and TB is biological plausible, where diabetes impairs the immune system and making it harder for the body to fight against infection. Methodology: Patients on DOTS therapy in continuation phase of anti-TB therapy, Patients with TB and Diabetes and Patients with TB alone were included in the study. Blood samples were collected and Fasting Blood Glucose (FBG), Post Prandial Glucose (PPG) and Glycated Hemoglobin (HbA1c) were measured to understand the glycemic status and its impact on TB treatment outcomes. Results: Our study confirms the fact that type II diabetes is a strong risk factor for tuberculosis and is associated with a slower response to TB treatment and a higher mortality rate. Incidence of TB is greatest among those with conditions impairing immunity such as DM. Diabetes impairs the immune system, making it harder for the body to fight against infection.

The impact of diabetes mellitus on the anti-tuberculous treatment outcome: a series of cases from the Republic of Moldova

“…The antituberculous treatment effectiveness was considerably lower in the diabetic group, through a higher mortality rate compared with non-diabetic patients. The obtained results were similar to other studies, that identified a high rate of death and treatment failure [6,7,[11][12][13][14][15][16][17]23,24]. All patients with DM received an individualized treatment, but in every fourth the glycemic control was not achieved.…”

“…Our research established that TB was diagnosed more often in patients with complications, in which the FVPG exceeded the normal limit. In the literature many studies established that patients with uncontrolled blood glucose level have high risk for occurrence of TB [11][12][13][14][15]23,25]. Although men are significantly more at a risk for contracting and dying from TB than women, our research established a similar distribution of the diabetic patients in groups according to the sex.…”

“…Our study and the literature established that the social and economic vulnerability constituted a risk factor for TB in patients with DM [6,7,[11][12][13][14][15][16]21,23,25]. However, our research established a high rate of the diabetic patients with free access to the screening procedures, due to specific conditions, like have been retired or disabled.…”

“…The rate of the adverse anti-tuberculous drug effects in diabetic patients ranges between 20% and 54%, according to the applied therapeutic regimen [13][14][15][16]. Uncontrolled hyperglycemia affects multiple organs, such as eyes, liver, kidney, nerves, and cardiovascular system [5,8].…”

“…Although usual localization is in the upper and posterior lung segments, in DM often appears in the segments III, IV and V, what contributes to the misdiagnosis [9]. The late detection and late onset of the anti-tuberculous therapy, dietary errors and inadequate antidiabetic treatment represent the causes of premature death in patients with DM and TB [5][6][7][8][9][10][11][12][13][14][15][16]. Considering all the above-mentioned data, the study has been performed with the aim to assess the impact of diabetes mellitus on the anti-tuberculous treatment effectiveness for improvement of the disease outcome.…”