肺部疾病与治疗杂志

Introduction:The negative impact of DM and glycemic control on tuberculosis outcomes has been the subject of controversy. Twenty percent of tuberculosis (TB) cases in México are also diabetic; adequate control of glycaemia in Mexican patients due to several socioeconomic factors is rarely accomplished. Our objective was to determine the impact of glycemic control on sputum conversion and to compare the time for sputum smear and culture conversion amongst TB patients with or without diabetes.
Setting: Referral center for drug-resistant TB and TB complications. Retrospective analysis of cases treated during a five year period.
Results: 88 patients were referred for treatment; 30 patients (34.1%) had DM as a comorbidity. Twenty-seven (30.6%) had TB due to a multidrug resistant (MDR) strain; of the 30 TB-DM patients, 13 had MDR-TB (43.3%). During follow-up, 27.6% of TB patients had converted their culture by day 60 vs. 26.6% of the TB + DM patients (p = 0.58). Culture conversion for TB + DM patients with HbA1c ≥ 6.5% took 74.7 ± 32.2 days vs. 90.0 ± 25.3 days in patients with TB + DM and an HbA1c < 6.5% (p = 0.26).
Conclusion: Time for smear and culture conversion was not significantly different in patients with TB and patients with TB + DM, including cases with inadequate glycemic control and those with MDR-TB.