title: The role of diabetes co-morbidity for tuberculosis treatment outcomes: a prospective cohort study from Mwanza, Tanzania.
abstract: BACKGROUND
  Due to the association between diabetes and pulmonary tuberculosis (TB), diabetes may threaten the control of TB. In a prospective cohort study nested in a nutrition trial, we investigated the role of diabetes on changes in anthropometry, grip strength, and clinical parameters over a five months follow-up period.
  
  
  METHODS
  Among pulmonary TB patients with known diabetes status, we assessed anthropometry and clinical parameters (e.g. haemoglobin) at baseline and after two and five months of TB treatment. A linear mixed-effects model (repeated measurements) was used to investigate the role of diabetes during recovery.
  
  
  RESULTS
  Of 1205 TB patients, the mean (standard deviation) age was 36.6 (13.0) years, 40.9% were females, 48.9% were HIV co-infected, and 16.3% had diabetes. TB patients with diabetes co-morbidity experienced a lower weight gain at two (1.3 kg, CI95% 0.5; 2.0, p = 0.001) and five months (1.0 kg, CI95% 0.3; 1.7, p = 0.007). Similarly, the increase in the level of haemoglobin was lower among TB patients with diabetes co-morbidity after two (Δ 0.6 g/dL, CI95% 0.3; 0.9 p < 0.001) and five months (Δ 0.5 g/dL, CI95% 0.2; 0.9 p = 0.004) of TB treatment, respectively.
  
  
  CONCLUSIONS
  TB patients initiating TB treatment with diabetes co-morbidity experience delayed recovery of body mass and haemoglobin, which are important for the functional recovery from disease.
authors: Department of Human Nutrition, University of Copenhagen, Frederiksberg, Denmark. daniel@faurholt-jepsen.dk
authors: Daniel
authors: D
authors: Faurholt-Jepsen
authors: Nyagosya
authors: N
authors: Range
authors: George
authors: G
authors: Praygod
authors: Jeremiah
authors: J
authors: Kidola
authors: Maria
authors: M
authors: Faurholt-Jepsen
authors: Martine Grosos
authors: MG
authors: Aabye
authors: John
authors: J
authors: Changalucha
authors: Dirk Lund
authors: DL
authors: Christensen
authors: Torben
authors: T
authors: Martinussen
authors: Henrik
authors: H
authors: Krarup
authors: Daniel Rinse
authors: DR
authors: Witte
authors: Åse Bengård
authors: ÅB
authors: Andersen
authors: Henrik
authors: H
authors: Friis
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D048909:Diabetes Complications; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013636:Tanzania; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy*
chemical_list: D006454:Hemoglobins