Impact of diabetes mellitus on treatment outcomes of patients with active tuberculosis.
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.
Dooley
Kelly E
KE
Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. kdooley1@jhmi.edu
Tang
Tania
T
Golub
Jonathan E
JE
Dorman
Susan E
SE
Cronin
Wendy
W
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D048909:Diabetes Complications / Q000188:drug therapy* / Q000401:mortality; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D055815:Young Adult
D000995:Antitubercular Agents