Effects of diabetes mellitus on the clinical presentation and treatment response in tuberculosis

Leung, Chi Chiu; Yew, Wing Wai; Mok, Thomas; Lau, Kam Shing; Wong, Chi Fong; Chau, CH; Chan, Chi Kuen; Chang, Kwok Chiu; Tam, Greta; Tam, Cheuk Ming

doi:10.1111/resp.13017

Cited by 38 publications

(32 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[11][12][13][14] Recent studies in Pakistan have shown more unfavourable outcomes among DS-TB patients with DM; 15,16 however, we could not find any relevant study examining the effect of DM on treatment outcomes among DR-TB patients in Pakistan.…”

contrasting

confidence: 47%

“…The lack of significant association observed between DM and DR-TB treatment outcome is consistent with findings from studies conducted in other countries, such as Georgia, Peru, Mexico and China. [11][12][13][14] However, studies in South Korea, Taiwan and Brazil have reported an association of DM with unfavourable outcomes. [7][8][9] These studies also report that unfavourable outcomes were significantly associated with poor glycaemic controls and other comorbidities caused by DM, such as chronic renal diseases, cardiovascular diseases and cerebrovascular diseases in patients with DM.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Did diabetes mellitus affect treatment outcome in drug-resistant tuberculosis patients in Pakistan from 2010 to 2014?

2018

Indian Journal of Tuberculosis

View full text Add to dashboard Cite

contrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Did diabetes mellitus affect treatment outcome in drug-resistant tuberculosis patients in Pakistan from 2010 to 2014?

2018

Indian Journal of Tuberculosis

View full text Add to dashboard Cite

“…47 In diabetic patients, there is more severe pulmonary disease radiologically and bacteriologically, more adverse drug effects, delayed smear and culture conversion, and unfavourable 1-year outcome with higher mortality. 49 DM has been associated with treatment failure, relapse and drug resistance in some studies, 48 However, with prolonged treatment duration of 9 months for TB patients with DM in Hong Kong, the relapse rate was not found to be significantly increased. 49 Despite the large cohort size, no association was seen between DM and bacillary resistance to isoniazid or rifampicin, likely due to the good programmatic performance locally.…”

Section: Smoking and Dm As Important Co-morbid Conditions Of Tb In Olmentioning

confidence: 99%

“…Furthermore, DM is predominantly associated with pulmonary TB, rather than extra‐pulmonary disease . In diabetic patients, there is more severe pulmonary disease radiologically and bacteriologically, more adverse drug effects, delayed smear and culture conversion, and unfavourable 1‐year outcome with higher mortality . DM has been associated with treatment failure, relapse and drug resistance in some studies, However, with prolonged treatment duration of 9 months for TB patients with DM in Hong Kong, the relapse rate was not found to be significantly increased .…”

Section: Smoking and Dm As Important Co‐morbid Conditions Of Tb In Olmentioning

confidence: 99%

Epidemiological, clinical and mechanistic perspectives of tuberculosis in older people

et al. 2018

Self Cite

View full text Add to dashboard Cite

With the ageing population globally, tuberculosis (TB) in older people becomes a major clinical and public health challenge. In many Asian countries, especially those located in the eastern and southeastern parts of the continent, geriatric TB is a significant problem. TB in the older patients is more difficult to diagnose in the early course of disease, and has poorer treatment outcomes, largely as increased failure and death. More drug-induced adverse reactions are also experienced by this population during TB therapy. Oxidative stress and mitochondrial dysfunction are now well recognized to be associated with the ageing process, and it is likely that the cellular and molecular perturbations interact inextricably with the immunological dysfunction biophysiologically inherent to ageing. These underlying mechanistic bases putatively contribute to the development of TB in the geriatric population and worsen the disease outcomes, especially when the TB is compounded by co-morbid conditions such as smoking and diabetes mellitus. Unravelling these mechanisms further would yield knowledge that might potentially help to prevent reactivated TB in older people, and also to better manage the established disease with drug regimens and other new therapeutic strategies. In addition, addressing the social elements associated with geriatric TB is also imperative in the relief of individual patient suffering and improvement of overall disease control.

show abstract

“…Increasing evidence is now available to show the substantial impact of host factors (e.g. smoking, diabetes mellitus, HIV, pharmacokinetics and pharmacogenetics) and disease characteristics (e.g. cavity, baseline and/or 2‐month smear/culture status) on various aspects of treatment outcomes.…”

Section: National Tb Control Strategy: Standardized Versus Individualmentioning

confidence: 99%

New drugs and regimens for tuberculosis

et al. 2018

Self Cite

View full text Add to dashboard Cite

Since standardized rifampin-based first-line regimens and fluoroquinolone-based second-line regimens were used to treat tuberculosis (TB), unfortunately without timely modification according to the drug resistance profile, TB and drug-resistant disease are still important public health threats worldwide. Although the last decade has witnessed advances in rapid diagnostic tools and use of repurposed and novel drugs for better managing drug-resistant TB, we need an appropriate TB control strategy and a well-functioning health infrastructure to ensure optimal operational use of rapid tests, judicious use of effective treatment regimens that can be rapidly tailored according to the drug resistance profile and timely management of risk factors and co-morbidities that promote infection and its progression to disease. We searched the published literature to discuss (i) standardized versus individualized therapies, including the choice between a single one-size-fit-all regimen versus different options with different key drugs determined mainly by rapid drug susceptibility testing, (ii) alternative regimens for managing drug-susceptible TB, (iii) evidence for using the World Health Organization (WHO) longer and shorter regimens for multidrug-resistant TB and (iv) evidence for using repurposed and novel drugs. We hope an easily applicable combination of biomarkers that accurately predict individual treatment outcome will soon be available to ultimately guide individualized therapy.

show abstract

Effects of diabetes mellitus on the clinical presentation and treatment response in tuberculosis

Abstract: DM adversely affected the clinical presentation and treatment response of TB, but there was no difference in the drug resistance and relapse rates.

Cited by 38 publications

References 29 publications

Did diabetes mellitus affect treatment outcome in drug-resistant tuberculosis patients in Pakistan from 2010 to 2014?

Did diabetes mellitus affect treatment outcome in drug-resistant tuberculosis patients in Pakistan from 2010 to 2014?

Epidemiological, clinical and mechanistic perspectives of tuberculosis in older people

New drugs and regimens for tuberculosis

Contact Info

Product

Resources

About