Effect of prediabetes on tuberculosis treatment outcomes: A study from South India.

Autor: Viswanathan V; Prof. M. Viswanathan Diabetes Research Centre, Royapuram, Chennai, India. Electronic address: drvijay@mvdiabetes.com., Devarajan A; Prof. M. Viswanathan Diabetes Research Centre, Royapuram, Chennai, India. Electronic address: epidemiologyresearch@mvdiabetes.com., Kumpatla S; Prof. M. Viswanathan Diabetes Research Centre, Royapuram, Chennai, India. Electronic address: adresearch@mvdiabetes.com., Dhanasekaran M; Prof. M. Viswanathan Diabetes Research Centre, Royapuram, Chennai, India. Electronic address: smedots@mvdiabetes.com., Babu S; National Institutes of Health-International Centre for Excellence in Research, National Institute for Research in Tuberculosis, Chennai, India. Electronic address: sbabu@icerindia.org., Kornfeld H; Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA. Electronic address: hardy.kornfeld@umassmed.edu.
Jazyk: angličtina
Zdroj: Diabetes & metabolic syndrome [Diabetes Metab Syndr] 2023 Jul; Vol. 17 (7), pp. 102801. Date of Electronic Publication: 2023 Jun 08.
DOI: 10.1016/j.dsx.2023.102801
Abstrakt: Background and Aims: The aim was to assess the effect of prediabetes on tuberculosis(TB) treatment outcomes.
Methods: This is a prospective observational cohort study of 569 eligible new smear positive cases screened for DM between 2014 and 2018 in TB units in North Chennai, South India. Based on study criteria, a total of 187 subjects were included and categorised into two groups: TB with normoglycaemia (groupI) (HbA1c<5.7%) and TB with prediabetes (group II) (HbA1c = 5.7-6.4%) and followed them at 3 rd and 6 th month and treatment outcomes were assessed at the end of the TB treatment.
Results: Total cure rate was 72.7% with no significant difference between the groups. Higher proportion of deaths occurred in group II (6.3%) compared to group I (1.3%) (p = 0.09). At the end of intensive phase of directly observed therapy (DOTS) treatment, about 23.8% were observed to have positive sputum smear in group II compared to 8.6% in group I(p = 0.019). The estimated relative risk to remain as sputum smear positive among people with prediabetes at the end of intensive phase was 3.0(95% CI: 1.2-7.6). There was a significant association found with HbA1c at enrollment and unfavourable TB treatment outcomes (β = 1.38, [odds ratio (95% CI) 3.98(1.65-9.64); p = 0.007].
Conclusion: Death rate was high and there was a delay in sputum conversion among TB patients with prediabetes at the end of the intensive phase of TB treatment. HbA1c at the time of diagnosis of prediabetes was significantly associated with unfavourable TB treatment outcomes.
Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest.
(Copyright © 2023 Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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