Persistent dysglycaemia dims tuberculosis treatment outcomes

Among patients with tuberculosis (TB) infection, treatment outcomes seem unfavourable in the presence of persistent dysglycaemia, as reported in a study.

A total of 125 TB patients were enrolled and followed for 24 months. Researchers measured dysglycaemia by fasting glucose and HbA1c at baseline and at the second and sixth months of TB treatment. Dysglycaemia was considered persistent if the condition was detected during two consecutive visits.

Of the patients, 29.6 percent (95 percent confidence interval [CI], 22.3–38.1) had persistent dysglycaemia while 52 percent (95 percent CI, 43.24–60.76) had normoglycaemia. Compared with the latter, the group with persistent dysglycaemia presented more lung lesion types (p<0.001), a higher bacillary load (p=0.013), higher body mass index (BMI; p=0.039), low haemoglobin levels (p<0.001), and were older (median age 47.3 vs 27.5 years; p<0.001).

TB treatment outcomes were poor among 29 TB patients (23 percent). They were more likely to be older (p<0.001) and have higher BMI (p=0.01), more lung lesion types (p=0.01), and persistent dysglycaemia (p<0.001) relative to patients with favourable treatment outcome. There was no between-group difference noted in other characteristics, including sex, history of prior TB, asthma, renal disease, alcohol use, smoking, and illicit drugs use.

In multivariable logistic regression models, persistent dysglycaemia was strongly associated with unfavourable treatment outcomes (adjusted odds ratio, 6.1, 95 percent CI, 1.9–19.6).

The findings underscore the importance of optimal control of whole dysglycaemic condition in the management of TB.