View : 85 Download: 0

The effect of diabetes control status on treatment response in pulmonary tuberculosis: a prospective study

Title
The effect of diabetes control status on treatment response in pulmonary tuberculosis: a prospective study
Authors
Yoon, Young SoonJung, Jae-WooJeon, Eun JuSeo, HaesookRyu, Yon JuYim, Jae-JoonKim, Yee HyungLee, Byoung-HoonPark, Yong BumLee, Byoung JunKang, HyunChoi, Jae Chol
Ewha Authors
류연주
SCOPUS Author ID
류연주scopus
Issue Date
2017
Journal Title
THORAX
ISSN
0040-6376JCR Link1468-3296JCR Link
Citation
vol. 72, no. 3, pp. 263 - 270
Publisher
BMJ PUBLISHING GROUP
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background Uncontrolled diabetes, unlike controlled diabetes, is associated with an impaired immune response. However, little is known about the impact of the status of diabetes control on clinical features and treatment outcomes in patients with pulmonary TB (PTB). We conducted this study to evaluate whether the status of diabetes control influences clinical manifestations and treatment responses in PTB. Methods A multicentre prospective study was performed between September 2012 and September 2014. The patients were categorised into three groups according to the glycated haemoglobin (HbA1C) level: PTB without diabetes mellitus (non-DM), PTB with controlled diabetes (controlled-DM) and PTB with uncontrolled diabetes (uncontrolled-DM). The primary outcome was the sputum culture conversion rate after 2 months of intensive treatment. Results Among 661 patients with PTB, 157 (23.8%) had diabetes and 108 (68.8%) had uncontrolled diabetes (HbA1C >= 7.0%). The uncontrolled-DM group exhibited more symptoms, positive sputum smears (p< 0.001) and presence of cavities (p< 0.001) than the non-DM group. Regarding treatment responses, patients with uncontrolled-DM were more likely to have a positive culture after 2 months (p= 0.009) and either treatment failure (p= 0.015) or death (p= 0.027) compared with the non-DM group. In contrast, those with controlled-DM showed similar treatment responses to the non-DM group. In multivariable analysis, uncontrolled diabetes was an independent risk factor for a positive sputum culture after 2 months of treatment (adjusted OR, 2.11; p= 0.042) and either treatment failure or death (adjusted OR, 4.11; p= 0.022). Conclusions Uncontrolled diabetes is an independent risk factor for poor treatment response in PTB.
DOI
10.1136/thoraxjnl-2015-207686
Appears in Collections:
의과대학 > 의학과 > Journal papers
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE