title: Clinical characteristics, drug resistance, and treatment outcomes among tuberculosis patients with diabetes in Peru.
abstract: OBJECTIVE
  Diabetes is a risk factor for active tuberculosis (TB). Data are limited regarding the association between diabetes and TB drug resistance and treatment outcomes. We examined characteristics of TB patients with and without diabetes in a Peruvian cohort at high risk for drug-resistant TB. Among TB patients with diabetes (TB-DM), we studied the association between diabetes clinical/management characteristics and TB drug resistance and treatment outcomes.
  
  
  METHODS
  During 2005-2008, adults with suspected TB with respiratory symptoms in Lima, Peru, who received rapid drug susceptibility testing (DST), were prospectively enrolled and followed during treatment. Bivariate and Kaplan-Meier analyses were used to examine the relationships of diabetes characteristics with drug-resistant TB and TB outcomes.
  
  
  RESULTS
  Of 1671 adult TB patients enrolled, 186 (11.1%) had diabetes. TB-DM patients were significantly more likely than TB patients without diabetes to be older, have had no previous TB treatment, and to have a body mass index (BMI) >18.5 kg/m(2) (p<0.05). In patients without and with previous TB treatment, the prevalence of multidrug-resistant TB was 23% and 26%, respectively, among patients without diabetes, and 12% and 28%, respectively, among TB-DM patients. Among 149 TB-DM patients with DST results, 104 (69.8%) had drug-susceptible TB and 45 (30.2%) had drug-resistant TB, of whom 29 had multidrug-resistant TB. There was no association between diabetes characteristics and drug-resistant TB. Of 136 TB-DM patients with outcome information, 107 (78.7%) had a favorable TB outcome; active diabetes management was associated with a favorable outcome.
  
  
  CONCLUSIONS
  Diabetes was common in a cohort of TB patients at high risk for drug-resistant TB. Despite prevalent multidrug-resistant TB among TB-DM patients, the majority had a favorable TB treatment outcome.
authors: Rollins School of Public Health, Emory University, Atlanta, USA.
authors: M J
authors: MJ
authors: Magee
authors: E
authors: E
authors: Bloss
authors: S S
authors: SS
authors: Shin
authors: C
authors: C
authors: Contreras
authors: H Arbanil
authors: HA
authors: Huaman
authors: J Calderon
authors: JC
authors: Ticona
authors: J
authors: J
authors: Bayona
authors: C
authors: C
authors: Bonilla
authors: M
authors: M
authors: Yagui
authors: O
authors: O
authors: Jave
authors: J P
authors: JP
authors: Cegielski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D003920:Diabetes Mellitus; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents