PT  - JOURNAL ARTICLE
AU  - María Eugenia Jiménez-Corona
AU  - Luis Pablo Cruz-Hervert
AU  - Lourdes García-García
AU  - Leticia Ferreyra-Reyes
AU  - Guadalupe Delgado-Sánchez
AU  - Miriam Bobadilla-del-Valle
AU  - Sergio Canizales-Quintero
AU  - Elizabeth Ferreira-Guerrero
AU  - Renata Báez-Saldaña
AU  - Norma Téllez-Vázquez
AU  - Rogelio Montero-Campos
AU  - Norma Mongua-Rodriguez
AU  - Rosa Areli Martínez-Gamboa
AU  - José Sifuentes-Osornio
AU  - Alfredo Ponce-de-León
TI  - Association of diabetes and tuberculosis: impact on treatment and post-treatment outcomes
AID  - 10.1136/thoraxjnl-2012-201756
DP  - 2013 Mar 01
TA  - Thorax
PG  - 214--220
VI  - 68
IP  - 3
4099  - http://thorax.bmj.com/content/68/3/214.short
4100  - http://thorax.bmj.com/content/68/3/214.full
SO  - Thorax2013 Mar 01; 68
AB  - Objective To determine the clinical consequences of pulmonary tuberculosis (TB) among patients with diabetes mellitus (DM). Methods We conducted a prospective study of patients with TB in Southern Mexico. From 1995 to 2010, patients with acid-fast bacilli or Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and microbiological evaluation. Annual follow-ups were performed to ascertain treatment outcome, recurrence, relapse and reinfection. Results The prevalence of DM among 1262 patients with pulmonary TB was 29.63% (n=374). Patients with DM and pulmonary TB had more severe clinical manifestations (cavities of any size on the chest x-ray, adjusted OR (aOR) 1.80, 95% CI 1.35 to 2.41), delayed sputum conversion (aOR 1.51, 95% CI 1.09 to 2.10), a higher probability of treatment failure (aOR 2.93, 95% CI 1.18 to 7.23), recurrence (adjusted HR (aHR) 1.76, 95% CI 1.11 to 2.79) and relapse (aHR 1.83, 95% CI 1.04 to 3.23). Most of the second episodes among patients with DM were caused by bacteria with the same genotype but, in 5/26 instances (19.23%), reinfection with a different strain occurred. Conclusions Given the growing epidemic of DM worldwide, it is necessary to add DM prevention and control strategies to TB control programmes and vice versa and to evaluate their effectiveness. The concurrence of both diseases potentially carries a risk of global spreading, with serious implications for TB control and the achievement of the United Nations Millennium Development Goals.