JMIR Publications

ABSTRACT

Background:

Diabetes Mellitus (DM) increases the risk of developing tuberculosis (TB) and optimal glycemic control has been shown to reduce the risk of complications and improve the TB treatment outcomes in patients with DM.

Objective:

This study aims to investigate the role of glycemic control in improving TB treatment outcomes among patients with DM.

Methods:

MEDLINE, Embase, and Cochrane Central databases were searched for RCTs assessing the impact of oral glycemic control in TB patients who had DM. Outcomes of interest were radiological findings, treatment success, sputum positivity, and mortality. Evaluations were reported as risk ratios with 95% confidence intervals using weighted random-effects models.

Results:

The analysis included 6,919 patients from 7 observational studies. Meta-analysis showed statistically significant difference between patients with optimal glycemic control (OGC) and those with poor glycemic control (PGC) in improving treatment outcome[RR 1.13, 95%CI (1.02,1.25), P=0.02, I²=65%] , reducing sputum positivity [RR 0.23, 95%CI (0.09,0.61), P=0.003, I²=66%] and lesser cavitary lesions [RR 0.59, 95%CI (0.51, 0.68), P<0.00001, I²=0%] on radiological findings. There was no significant difference between the two groups in terms of mortality(RR 0.57, 95%CI (0.22,1.49), P=0.25, I²=0%], multilobar involvement (RR 0.57, 95%CI (0.22,1.49), P=0.25, I²=0%] on radiology, upper lobe [RR 0.94, 95% CI (0.76,1.17), P=0.58, I²=0%] and lower lobe [RR 1.05, 95% CI (0.48,2.30), P=0.91, I²=75%] involvement on radiology.

Conclusions:

we concluded that optimal glycemic control is crucial for reducing susceptibility, minimizing complications, and improving treatment outcomes in TB patients with DM. Emphasizing effective health management and healthcare strategies is essential in achieving this control. Integrating comprehensive care in TB patients with DM will enhance patient outcomes and alleviate the burden of disease in this population.