Patients suffering from both tuberculosis (TB) and diabetes do not respond as well to tuberculosis therapy as those who are non-diabetic. Diabetes is a known risk factor for TB, and with the increasing prevalence of diabetes in developing countries many patients with TB will also have diabetes. Presently, little is known about the effect of diabetes on the clinical presentation and treatment outcome of TB. Researchers from the Radboud University Medical Center in Nijmegen studied 737 Indonesian patients suffering from TB. These patients were screened for type-2 diabetes, also referred to as adult-onset diabetes, and then followed while receiving tuberculosis therapy. Overall, about 15 per cent of the patients had diabetes. Despite initially having more symptoms, the patients with diabetes had TB that was comparable in severity to that in non-diabetics. However, after two months of treatment, sputum test results were more likely to be positive in diabetic patients, 18 per cent to 10 per cent in non-diabetics. At six months, the diabetics were still significantly more likely to have positive sputum test results than the non-diabetic patients, at about 22 per cent versus 10 per cent, respectively. Thus, diabetes seems to have a negative effect on the outcome of TB treatment. Screening for diabetes and subsequent control of blood sugar may improve the outcome of TB treatment. However, further research is warranted to understand how the current global epidemic of diabetes affects tuberculosis control and prevention.
Clinical Infectious Diseases,
August 2007