Is There an Effect of Glucose Lowering Treatment on Incidence and Prognosis of Tuberculosis? A Systematic Review

Jørgensen, Marit Eika; Faurholt‐Jepsen, Daniel

doi:10.1007/s11892-014-0505-1

Cited by 18 publications

(26 citation statements)

References 47 publications

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“…A unifying factor from epidemiological, clinical and immunological studies in the past and current literature on TB and DM is the importance of glucose control [43]. This is consistent with the clinical management and outcome of other DM complications, where the beneficial effects of glucose control for the prevention of microvascular and macrovascular complications are generally accepted.…”

Section: Impact Of Dm On Other Aspects Of the Association Between mentioning

confidence: 82%

“…Therefore, we summarize the adverse outcomes in order to evaluate their possible underlying mechanisms. We refer the reader to recent systematic reviews and meta-analyses on this topic for a more detailed description of the individual studies [35;41;43]. DM is most often associated with delayed mycobacterial clearance from sputum during the course of treatment (reviewed by [41;43]).…”

Section: Impact Of Dm On Tb Treatment Outcomesmentioning

confidence: 99%

“…We refer the reader to recent systematic reviews and meta-analyses on this topic for a more detailed description of the individual studies [35;41;43]. DM is most often associated with delayed mycobacterial clearance from sputum during the course of treatment (reviewed by [41;43]). That is, TB-DM versus TB-no DM patients have a higher proportion of smear-positives after completion of the intensive phase of treatment, or longer median days-to-mycobacterial clearance from sputum.…”

Section: Impact Of Dm On Tb Treatment Outcomesmentioning

confidence: 99%

“…Hyperglycemia may also compromise Mtb killing by affecting the microvasculature and reducing lung tissue perfusion for optimal immune surveillance [46]. However, the need for intervention studies to assess the effect of glucose control on TB treatment outcomes is questionable [43], and the WHO considers that the available data is sufficient to recommend optimized glucose control as part of the management of TB-DM patients for improved TB outcomes [47]. The second suspect is possible suboptimal plasma levels of anti-mycobacterial antibiotics in the DM versus non-DM patients [48–50].…”

Section: Impact Of Dm On Tb Treatment Outcomesmentioning

confidence: 99%

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Impact of diabetes on the natural history of tuberculosis

Restrepo¹,

Schlesinger²

2014

Diabetes Research and Clinical Practice

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Tuberculosis (TB) is the number one bacterial killer worldwide and the current increase in type 2 diabetes mellitus patients (DM), particularly in countries where TB is also endemic, has led to the re-emerging importance of DM2 as a risk factor for TB. There is an urgent need to implement strategies for TB prevention among the millions of DM patients exposed to Mycobacterium tuberculosis (Mtb) worldwide, but knowledge is limited on how and when DM2 alters the natural history of this infection. In this review we summarize the current epidemiological, clinical and immunologic studies on TB and DM and discuss the clinical and public health implications of these findings. Specifically, we evaluate the mechanisms by which DM patients have a higher risk of Mtb infection and TB development, present with signs and symptoms indicative of a more infectious TB infection, and are more likely to have adverse TB treatment outcomes, including death. Emphasis is placed on type 2 DM given its higher prevalence in contemporary times, but the underlying role of hyperglycemia and of type 1 DM is also discussed.

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Section: Impact Of Dm On Other Aspects Of the Association Between mentioning

confidence: 82%

Section: Impact Of Dm On Tb Treatment Outcomesmentioning

confidence: 99%

Section: Impact Of Dm On Tb Treatment Outcomesmentioning

confidence: 99%

Section: Impact Of Dm On Tb Treatment Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Impact of diabetes on the natural history of tuberculosis

Restrepo¹,

Schlesinger²

2014

Diabetes Research and Clinical Practice

View full text Add to dashboard Cite

show abstract

“…Hyperglycemia may also compromise Mtb killing by affecting the microvasculature and reducing lung tissue perfusion for optimal immune surveillance. However, the need for intervention studies to assess the effect of glucose control on TB treatment outcomes is questionable (55), and the WHO considers that the available data is sufficient to recommend optimized glucose control as part of the management of TB-DM patients for improved TB outcomes (56). The second suspect is possible suboptimal plasma levels of anti-mycobacterial antibiotics in the DM versus non-DM patients (57-59).…”

Section: Tb Treatment Outcomes In Tb-dm Patientsmentioning

confidence: 99%

Diabetes and Tuberculosis

2016

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The increase in type 2 diabetes mellitus (DM) patients in countries where tuberculosis (TB) is also endemic has led to the reemerging importance of DM as a risk factor for TB. DM causes a 3-fold increase in TB risk and a 2-fold increase in adverse TB treatment outcomes. Given the sheer numbers of DM patients worldwide, there are now more TB patients with TB-DM comorbidity than TB-HIV coinfection. There is an urgent need to implement strategies for TB prevention and control among the millions of DM patients exposed to Mycobacterium tuberculosis . This chapter summarizes the current epidemiological, clinical, and immunological knowledge on TB and DM and their clinical and public health implications. These include the underlying mechanisms for TB risk in DM patients and their clinical and sociodemographic characteristics that distinguish them from TB patients without DM. TB-DM comorbidity is posing a new challenge for integrating the short-term care for TB with the long-term care for DM, particularly in low- and middle-income countries.

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Diabetes and Tuberculosis

Restrepo¹

2018

Understanding the Host Immune Response Against Mycobacterium Tuberculosis Infection

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DM as a risk factor for TB Diabetes prevalence has increased worldwide as a result of population ageing, urbanisation, changes in diet and reduced physical activity patterns resulting in increasing obesity (11). About 80% of the 415 million estimated DM cases globally are from low and middle income countries and the DM prevalence is projected to rise most steeply in regions with high TB incidence over the next 30 years (9). A systematic review of 13 observational studies found that DM increases the risk of TB by threefold (relative risk 3.11; 95% CI 2.27-4.26).(3) Even though this is the best-characterized aspect of the association between TB and DM, these findings present wide variation between studies with risk ratios ranging between

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Is There an Effect of Glucose Lowering Treatment on Incidence and Prognosis of Tuberculosis? A Systematic Review

Cited by 18 publications

References 47 publications

Impact of diabetes on the natural history of tuberculosis

Impact of diabetes on the natural history of tuberculosis

Diabetes and Tuberculosis

Diabetes and Tuberculosis

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