Effect of complicated, untreated and uncontrolled diabetes and pre-diabetes on treatment outcome among patients with pulmonary tuberculosis

Respirology. 2024 Jul;29(7):624-632. doi: 10.1111/resp.14714. Epub 2024 Mar 27.

Abstract

Background and objective: Patients with tuberculosis and diabetes have a higher risk of unfavourable anti-tuberculosis treatment outcomes. In the present study, we aimed to evaluate the effects of various diabetes statuses on the outcomes of patients with pulmonary tuberculosis.

Methods: Among the patients with pulmonary tuberculosis enrolled in the Korea Tuberculosis Cohort (KTBC) registry and the multicentre prospective cohort study of pulmonary tuberculosis (COSMOTB), those with diabetes and complicated diabetes were identified. The primary and secondary outcomes were unfavourable outcomes and mortality, respectively. The effect of diabetes and complicated diabetes on the outcomes was assessed using multivariable logistic regression analysis. Using COSMOTB, subgroup analyses were performed to assess the association between various diabetes statuses and outcomes.

Results: In the KTBC, diabetes (adjusted odds ratio [aOR] = 1.93, 95% CI = 1.64-2.26) and complicated diabetes (aOR = 1.96, 95% CI = 1.67-2.30) were significantly associated with unfavourable outcomes, consistent with the COSMOTB data analysis. Based on subgroup analysis, untreated diabetes at baseline was an independent risk factor for unfavourable outcomes (aOR = 2.72, 95% CI = 1.26-5.61). Prediabetes and uncontrolled diabetes increased unfavourable outcomes and mortality without statistical significance.

Conclusion: Untreated and complicated diabetes at the time of tuberculosis diagnosis increases the risk of unfavourable outcomes and mortality.

Keywords: diabetes mellitus; mortality; pre‐diabetes; treatment outcome; tuberculosis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antitubercular Agents* / therapeutic use
  • Diabetes Complications
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prediabetic State* / complications
  • Prediabetic State* / epidemiology
  • Prospective Studies
  • Registries
  • Republic of Korea / epidemiology
  • Risk Factors
  • Treatment Outcome
  • Tuberculosis, Pulmonary* / complications
  • Tuberculosis, Pulmonary* / drug therapy
  • Tuberculosis, Pulmonary* / epidemiology
  • Tuberculosis, Pulmonary* / mortality

Substances

  • Antitubercular Agents