The challenges in the management of drug-resistant tuberculosis in patients with diabetes mellitus

Abstract

Background. Drug resistant tuberculosis (TB) in diabetic patients represents the challenger for TB control. Impairment of glycolic metabolism reduced cellular immunity, resistance to insulin Results. in affection of anti-TB drugs pharmacokinetics. Such patients are need the intensive and longer therapeutic regimens. Objective(s). The Objective(s). of the study was to evaluate the clinical, laboratory investigations particularities, and treatment outcomes of drug-resistant tuberculosis in patients with diabetes mellitus. Materials and methods. The research included 45 patients diagnosed with TB and diabetes mellitus and undergoing treatment at the Municipal Clinical Hospital of Phthisiopneumology, Chisinau during period 2022-2024. The patient’s clinical and laboratory data were extracted from the observation sheets and statistically analyzed using the non-parametric Fisher exact test. Results. Resistant TB was dominated in patients aged 31–40 y.o. - 23(53%) cases, with Type 2 of Diabetes Miletus (DM) 41(91%), unemployed - 25(56%) patients. Labor migrants were 13(29%) patients. Comorbid status had 22(49%) patients (at least one comorbidity). The most of cases (41/91.1%) were identified by passive case-finding with positive Results. s of sputum smear in 27 (60.0%) cases. Household TB contact was identified in 9(42.9%) cases. Bilateral process with destruction had 22(48.9%) patients. The most prevalent resistance pattern was HRES in 10(22%) cases. Treatment success achieved in 27(60%) patients, 5(11.1%) patients died. Conclusion(s). Management of TB in the presence of coexisting diabetes mellitus is difficult. Patients are more sensitive to TB infection and at high risk of developing TB, with more rapid progression of disease, raised likelihood of drug resistance, poor treatment outcomes, therapeutic failure and death.