Primary diagnosed diabetes mellitus in patients with multidrugresistant tuberculosis

Abstract

Background. The association between tuberculosis (TB) and diabetes mellitus (DM) is characterized by a more severe clinical course of both conditions, potentially prolonged treatment duration, and an increased risk of both pulmonary and metabolic complications, thus increasing the risk of mutual aggravation. Objective(s). To assess the prevalence of DM and the frequency of newly diagnosed DM among patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB), and to estimate the severity of the comorbidity. Materials and methods. The study that was performed is a retrospective, observational cohort study. The study included all the patients that were diagnosed with MDR-PTB and were hospitalized in the MDR-TB department of the "Chiril Draganiuc" Institute of Pneumology in Chișinău, Republic of Moldova, during the following period: January - April 2022. Results. The study cohort included 57 patients with MDR-PTB, of whom 10 (17.5%) had DM. In 4 of the 10 cases (40%), DM was newly diagnosed at the time of MDR-PTB diagnosis was established in these patients. Patients with DM had similar demographic characteristics to those without DM, indicating a clear predominance of males (8/10 [80%] vs. 35/47 [74.4%], p=1.0) and comparable age distribution (median age 50 [IQR 37–66] vs. 40 [IQR 25–47] years, p=0.6). At the same time, patients affected by both MDR-TB and DM had a significantly higher rate of cavitary lesions detected on chest X-ray (9/10 [90%] vs. 15/47 [31.9%], p=0.001). Conclusion(s). DM is a frequent comorbidity among patients with MDR-TB, with a concerning proportion of cases being newly diagnosed. The radiological presentation of MDR-PTB in patients with DM is more severe. These two aspects support the necessity for systematic screening for DM in patients with MDR-TB.