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. 2015 Jun;19(6):685-92.
doi: 10.5588/ijtld.14.0811.

Diabetes mellitus is associated with cavities, smear grade, and multidrug-resistant tuberculosis in Georgia

M J Magee  1 , R R Kempker  2 , M Kipiani  3 , N R Gandhi  4 , L Darchia  3 , N Tukvadze  3 , P P Howards  5 , K M V Narayan  5 , H M Blumberg  4
Affiliations

Diabetes mellitus is associated with cavities, smear grade, and multidrug-resistant tuberculosis in Georgia

M J Magee et al. Int J Tuberc Lung Dis. 2015 Jun.

Abstract

Setting: National tuberculosis (TB) treatment facility in the country of Georgia.

Objective: To determine the prevalence of diabetes mellitus (DM) and pre-DM among patients with TB using glycosylated-hemoglobin (HbA1c), and to estimate the association between DM and clinical characteristics and response to anti-tuberculosis treatment.

Design: A cohort study was conducted from 2011 to 2014 at the National Centre for TB and Lung Disease in Tbilisi. Patients aged ⩾ 35 years with pulmonary TB were included. HbA1c was used to define DM (⩾ 6.5%), pre-DM (⩾ 5.7-6.4%), and no DM (<5.7%). Interviews and medical chart abstraction were performed. Regression analyses estimated associations between DM and 1) baseline TB characteristics and 2) anti-tuberculosis treatment outcomes.

Results: A total of 318 newly diagnosed patients with TB were enrolled. The prevalence of DM and pre-DM was 11.6% and 16.4%, respectively. In multivariable analyses, patients with TB-DM had more cavitation (adjusted OR [aOR] 2.26), higher smear grade (aOR 2.37), and more multidrug-resistant TB (MDR-TB) (aOR 2.27) than patients without DM. The risk of poor anti-tuberculosis treatment outcomes was similar among patients with and those without DM (28.1% vs. 23.6%).

Conclusion: DM and pre-DM were common among adults with newly diagnosed pulmonary TB in Tbilisi, Georgia, and DM was associated with more clinical symptoms, and MDR-TB, at presentation.

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Conflict of interest statement

Conflicts of interest: The others have no conflicts of interest to declare.

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