Universidad Peruana Cayetano Heredia

Diabetes mellitus among pulmonary tuberculosis patients from four TB-endemic countries: the TANDEM study

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dc.contributor.author Ugarte Gil, Cesar Augusto
dc.contributor.author Alisjahbana, Bachti
dc.contributor.author Ronacher, Katharina
dc.contributor.author Riza, Anca Lelia
dc.contributor.author Koesoemadinata, Raspati C.
dc.contributor.author Malherbe, Stephanus T.
dc.contributor.author Cioboata, Ramona
dc.contributor.author Llontop, Juan Carlos
dc.contributor.author Kleynhans, Leanie
dc.contributor.author Lopez, Sonia
dc.contributor.author Santoso, Prayudi
dc.contributor.author Marius, Ciontea
dc.contributor.author Villaizan, Katerine
dc.contributor.author Ruslami, Rovina
dc.contributor.author Walzl, Gerhard
dc.contributor.author Panduru, Nicolae Mircea
dc.contributor.author Dockrell, Hazel M.
dc.contributor.author Hill, Philip C.
dc.contributor.author Mc Allister, Susan
dc.contributor.author Pearson, Fiona
dc.contributor.author Moore, David Alexander James
dc.contributor.author Critchley, Julia A.
dc.contributor.author van Crevel, Reinout
dc.date.accessioned 2019-07-04T16:59:29Z
dc.date.available 2019-07-04T16:59:29Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6768
dc.description.abstract BACKGROUND: Diabetes mellitus (DM) increases the risk of active tuberculosis (TB) and worsens TB outcomes, putting TB control in jeopardy especially in TB endemic countries with rising DM prevalence rates. We assessed DM status and clinical correlates in TB patients across settings in Indonesia, Peru, Romania and South Africa. METHODS: Age-adjusted DM prevalence was estimated using laboratory glycated haemoglobin (HbA1c) or fasting plasma glucose (FPG) in TB patients. Detailed and standardized socio-demographic, anthropometric and clinical measurements were made. Characteristics of TB patients with or without DM were compared using multi-level mixed effect regression models with robust standard errors. RESULTS: Of 2185 TB patients (median age 36.6 years, 61.2% male, 3.8% human immunodeficiency virus–infected), 12.5% (267/2128) had DM, one third of whom were newly diagnosed. Age-standardized DM prevalence ranged from 10.9% (South Africa) to 19.7% (Indonesia). Median HbA1c in TB–DM patients ranged from 7.4% (Romania) to 11.3% (Indonesia). Compared to those without DM, TB–DM patients were older and had a higher body mass index (BMI) (P value < .05). Compared to those with newly diagnosed DM, TB patients with diagnosed DM had higher BMI and HbA1c, less severe TB, and more frequent comorbidities, DM complications, and hypertension (P value < .05). CONCLUSIONS: We show that DM prevalence and clinical characteristics of TB–DM vary across settings. Diabetes is primarily known but untreated, hyperglycemia is often severe, and many patients with TB–DM have significant cardiovascular disease risk and severe TB. This underlines the need to improve strategies for better clinical management of combined TB and DM. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Clinical Infectious Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Tuberculosis en_US
dc.subject Prevalence en_US
dc.subject Diabetes en_US
dc.subject HbA1c en_US
dc.subject Syndemic en_US
dc.title Diabetes mellitus among pulmonary tuberculosis patients from four TB-endemic countries: the TANDEM study en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/cid/ciz284
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1537-6591


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