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Home / The International Journal of Tuberculosis and Lung Disease, Volume 19, Number 6

Diabetes mellitus is associated with cavities, smear grade, and multidrug-resistant tuberculosis in Georgia

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SETTING: National tuberculosis (TB) treatment facility in the country of Georgia.

OBJECTIVE: To determine the prevalence of diabetes mellitus (DM) and pre-DM among patients with TB using glycosylated-hemoglobin (HbA1c), and to estimate the association between DM and clinical characteristics and response to anti-tuberculosis treatment.

DESIGN: A cohort study was conducted from 2011 to 2014 at the National Centre for TB and Lung Disease in Tbilisi. Patients aged 35 years with pulmonary TB were included. HbA1c was used to define DM (6.5%), pre-DM (5.7–6.4%), and no DM (<5.7%). Interviews and medical chart abstraction were performed. Regression analyses estimated associations between DM and 1) baseline TB characteristics and 2) anti-tuberculosis treatment outcomes.

RESULTS: A total of 318 newly diagnosed patients with TB were enrolled. The prevalence of DM and pre-DM was 11.6% and 16.4%, respectively. In multivariable analyses, patients with TB-DM had more cavitation (adjusted OR [aOR] 2.26), higher smear grade (aOR 2.37), and more multidrug-resistant TB (MDR-TB) (aOR 2.27) than patients without DM. The risk of poor anti-tuberculosis treatment outcomes was similar among patients with and those without DM (28.1% vs. 23.6%).

CONCLUSION: DM and pre-DM were common among adults with newly diagnosed pulmonary TB in Tbilisi, Georgia, and DM was associated with more clinical symptoms, and MDR-TB, at presentation.

Keywords: epidemiology; hemoglobin A1c; hyperglycemia; treatment failure

Document Type: Research Article

Affiliations: 1: Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, USA; Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, USA 2: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA 3: National Center for Tuberculosis and Lung Diseases, Tbilisi, Republic of Georgia, USA 4: Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, USA; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA 5: Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, USA

Publication date: 01 June 2015

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