Researchers Call for Improvements to TB-Diabetes Management

Strategies for better clinical management of comorbid tuberculosis (TB) and diabetes mellitus (DM) are needed, according to authors of a new analysis. This determination comes after the researchers found that patients with the 2 conditions often no not receive treatment for their diabetes and also have severe hyperglycemia, significant cardiovascular disease risk, and severe TB.

To reach this conclusion, the researchers assessed DM status and clinical correlates in 2185 patients with TB across settings in Indonesia, Peru, Romania, and South Africa—4 TB-endemic countries. The patients’ median age was 36.6 years; 61.2% were men, and 3.8% had HIV. 

According to the study authors, DM prevalence and clinical characteristics of TB–DM varied across the settings.

Laboratory glycated hemoglobin (HbA1c) or fasting plasma glucose was used to estimate the age-adjusted DM prevalence among the individuals with TB. Age-standardized DM prevalence ranged from 10.9% in South Africa to 19.7% in Indonesia. Meanwhile, median HbA1c among patients with TB and DM ranged from 7.4% in Romania to 11.3% in Indonesia.

Overall, 12.5% of the patients had DM. The researchers compared the characteristics of these patients with the characteristics of patients with TB alone. This analysis showed that patients with TB and DM were older and had a higher body mass index (BMI).

The DM diagnosis was new among one-third of patients with DM and TB. These patients had higher BMI and HbA1c; less severe TB; and more frequent comorbidities, DM complications, and hypertension compared with the patients who had already had a DM diagnosis.

—Colleen Murphy

Reference:

Ugarte-Gil C, Alisjahbana B, Ronacher K, et al; TANDEM Consortium. Diabetes mellitus among pulmonary tuberculosis patients from 4 tuberculosis-endemic countries: the TANDEM Study. Clin Infect Dis. 2020;70(5):780-788. https://doi.org/10.1093/cid/ciz284.