Diabetes mellitus affects the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis
BMC Infectious Diseases·
- DOI
- 10.1186/s12879-023-08765-0
- PMID
- 37986146
- PMCID
- PMC10662654
- OpenAlex
- W4388834144
- Study type
- Systematic review
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Publication version
This article has a linked preprint
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Open linked preprint →Why this research matters now
The findings suggest that diagnosing diabetes in drug-resistant and multidrug-resistant tuberculosis patients is important, and that glucose control and therapeutic monitoring during treatment may improve outcomes. The intersection of tuberculosis and diabetes represents a challenge for tuberculosis control programs globally.
Structured evidence summary
Research question
The study examined whether diabetes mellitus affects treatment outcomes in patients with drug-resistant tuberculosis and multidrug-resistant tuberculosis.
Study design
This was a systematic review and meta-analysis following PRISMA guidelines. The authors searched five databases for English-language literature published through July 2022 and synthesized findings using fixed-effects or random-effects models to calculate pooled odds ratios.
Population and setting
The meta-analysis included 16,905 drug-resistant tuberculosis participants across twenty-five studies, of whom 10,124 had multidrug-resistant tuberculosis and 1,952 had a history of diabetes mellitus.
Main findings
Among drug-resistant tuberculosis patients, diabetes mellitus was associated with higher odds of unsuccessful outcomes, treatment failure, and lower odds of cure and treatment completion. Similar patterns were observed in the multidrug-resistant tuberculosis subgroup, with diabetes linked to increased unsuccessful outcomes and treatment failure, and decreased cure and treatment completion rates.
Public-health relevance
The findings suggest that diagnosing diabetes in drug-resistant and multidrug-resistant tuberculosis patients is important, and that glucose control and therapeutic monitoring during treatment may improve outcomes. The intersection of tuberculosis and diabetes represents a challenge for tuberculosis control programs globally.
Important limitations
This summary relies on the supplied abstract and metadata only. Access to the full paper would be required for decision-grade interpretation, including assessment of study heterogeneity, publication bias, individual study quality, and the specific populations and settings represented in the included studies.
GIDS interpretation
This systematic review addresses the clinical intersection of antimicrobial resistance and chronic disease management in tuberculosis. The classifier links indicate relevance to antimicrobial resistance, health policy, and treatment topics, making the paper discoverable to surveillance teams monitoring tuberculosis control challenges and comorbidity impacts on treatment success.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.