‘TB patients with diabetes have 2.5 times higher risk of death’

Pulmonary tuberculosis (TB) patients with diabetes complications have poorer treatment outcomes and a higher risk of death, according to a study by Korean researchers published in an international journal.

It was the first large-scale study to analyze data on pulmonary tuberculosis patients in Korea.

The researchers said Wednesday that they analyzed data from the Korean Tuberculosis Cohort to determine the impact of diabetes and glycemic control on treating TB patients in Korea.

Professors Min Jin-soo (left) and Kim Kyung-hoon

Professor Min Jin-soo (corresponding author) of the Department of Respiratory Medicine at the Catholic University of Korea Seoul St. Mary’s Hospital and Professor Kim Kyung-hoon (first author) of the Department of Respiratory Medicine at St. Mary's Incheon Hospital led the study.

TB patients with diabetes are known to be at high risk of treatment failure. However, data on the impact of diabetes status on treatment outcomes are scarce, and there have been no large-scale studies involving Korean patients.

Professor Min’s team analyzed patients with diabetes and complications enrolled in the Pulmonary Tuberculosis Multicenter Prospective Tuberculosis Cohort Study database. It evaluated their impact on treatment outcomes using multivariate logistic regression analysis. The team also performed additional analyses to assess the association of different diabetes statuses (untreated and uncontrolled diabetes, pre-diabetes) with outcomes.

The results showed that compared to TB patients without diabetes, TB patients with diabetes were 1.6 times more likely to have poor TB treatment outcomes and 1.8 times more likely to have diabetes complications.

In addition, the risk of death was 2.5 times higher for TB patients with diabetes complications and 4.7 times higher for TB patients with diabetes but untreated diabetes. It means that patients with untreated diabetes were at higher risk of death, treatment discontinuation, and treatment failure during TB treatment, according to the researchers.

"It is necessary to screen for diabetes early in the diagnosis of TB and during treatment, and it is important to identify the glycemic control status of diabetic patients at the time of TB diagnosis to combat TB,” Professor Min said. “Active diabetes management is also essential to increase the cure rate of TB treatment."

The paper, “Effect of complicated, untreated and uncontrolled diabetes and pre-diabetes on treatment outcome among patients with pulmonary tuberculosis,” was published in the latest issue of Respirology, the official international journal of the Asia-Pacific Respiratory Society.

Meanwhile, Professor Min was selected for the Tuberculosis Cohort Study, a policy research project of the National Institutes of Health, and has been running the “Cohort Study of Pulmonary Tuberculosis COSMOTB)” as a principal investigator since 2019.