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. 2009 Apr;80(4):634-9.

Impact of diabetes mellitus on treatment outcomes of patients with active tuberculosis

Kelly E Dooley  1 , Tania Tang, Jonathan E Golub, Susan E Dorman, Wendy Cronin
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Impact of diabetes mellitus on treatment outcomes of patients with active tuberculosis

Kelly E Dooley et al. Am J Trop Med Hyg. 2009 Apr.

Abstract

Diabetes mellitus (DM) is an emerging chronic health condition of developed and developing countries. We conducted a retrospective cohort study of patients with active, culture-confirmed tuberculosis (TB) in Maryland to determine the impact of DM on TB treatment outcomes. Of 297 TB patients, 42 (14%) had DM. Patients with diabetes had 2.0 times higher odds of death than patients without diabetes (95% confidence interval [CI] 0.74-5.2, P = 0.18). Adjusting for human immunodeficiency virus (HIV), age, weight, and foreign birth, the odds of death were 6.5 times higher in patients with diabetes than patients without diabetes (95% CI 1.1-38.0, P = 0.039). In pulmonary TB patients, time to sputum culture conversion was longer in patients with diabetes than patients without diabetes (median 49 versus 39 days, P = 0.09). Two-month culture conversion proportions were similar (70% and 69%). Treatment failure occurred in 4.1% of patients without diabetes and 6.7% of patients with diabetes (P = 0.51). In conclusion, DM was a risk factor for death in Maryland TB patients. There was a trend toward increased time to culture conversion; two-month culture conversion proportions, however, were similar.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival analysis showing days to sputum culture conversion in patients with culture-positive pulmonary TB, comparing patients with diabetes to patients without diabetes.
Figure 2
Figure 2
Kaplan-Meier survival analysis showing days to sputum culture conversion in patients with cavitary (panel A) and noncavitary (panel B) pulmonary TB, comparing patients with diabetes to patients without diabetes.
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References

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