Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance

Chang, Jenn Tyang; Dou, Horng-Yunn; Yen, Chia Liang; Wu, Ying; Huang, Ruay Ming; Lin, Huey Juan; Su, Ih Jen; Shieh, Chi Chang

doi:10.1016/s0929-6646(11)60055-7

Cited by 137 publications

(138 citation statements)

References 24 publications

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“…This result is comparable to the result reported in Fiji [31], in Ethiopia [32] and those reported by Kelly Dooley in 2009 [33] but different from the reported study in China [34] in Texas-Mexico [35], Taiwan [36], Maharashtra-India [37], Saudi Arabia [38], and Turkey [39] where sputum conversion among TBDM patient groups were lower. The good sputum conversions observed in both patient groups in our study may be related to good treatment adherence among patients.…”

Section: Discussionsupporting

confidence: 75%

Prevalence, Predictors and Treatment Outcome of Type 2 Diabetes among Newly Diagnosed Sputum Positive Pulmonary Tuberculosis Patients in Western Cameroon

Fonkeng¹

2017

J Infect Dis Epidemiol

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Section: Discussionsupporting

confidence: 75%

Prevalence, Predictors and Treatment Outcome of Type 2 Diabetes among Newly Diagnosed Sputum Positive Pulmonary Tuberculosis Patients in Western Cameroon

Fonkeng¹

2017

J Infect Dis Epidemiol

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“…For example Chang et al reported a delayed clearance of mycobacteria in patients with TB + DM when compared with TB patients without DM (2.5 ± 3.0 months vs. 1.6 ± 1.4 months, p < 0.01) [2].…”

Section: Discussionmentioning

confidence: 99%

“…The bacteriological conversion has been reported to be slower in patients with DM in comparison to that of non-diabetic patients in some reports [2][3][4], and uncontrolled DM (HbA1c ≥ 7) has been reported as a significant risk factor for positive sputum culture after two months [5]. Other reports, however, do not show DM to be an independent risk factor associated with increased time to sputum conversion [6] or any relation between DM and sputum conversion rate at the end of the 2nd month [7,8].…”

Section: Introductionmentioning

confidence: 99%

Glycemic Control and Rate of Sputum Conversion in Diabetic Patients with Pulmonary Tuberculosis

Oceguera¹

2016

Lung Dis Treat

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“…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. Conflicting results might be due to the control status of DM.…”

Section: Sputummentioning

confidence: 96%

“…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. There is no correlation of mean A1c level with symptomatology.…”

Section: Sputummentioning

confidence: 99%

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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Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance

Abstract: DMTB patients have more severe TB infections, which require longer treatment and are more likely to develop MDR-TB than are patients with TB alone.

Cited by 137 publications

References 24 publications

Prevalence, Predictors and Treatment Outcome of Type 2 Diabetes among Newly Diagnosed Sputum Positive Pulmonary Tuberculosis Patients in Western Cameroon

Prevalence, Predictors and Treatment Outcome of Type 2 Diabetes among Newly Diagnosed Sputum Positive Pulmonary Tuberculosis Patients in Western Cameroon

Glycemic Control and Rate of Sputum Conversion in Diabetic Patients with Pulmonary Tuberculosis

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

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