Diabetes mellitus among pulmonary tuberculosis patients from 4 tuberculosis-endemic countries : the TANDEM study

dc.contributor.authorUgarte-Gil, Cesaren_ZA
dc.contributor.authorAlisjahbana, Bachtien_ZA
dc.contributor.authorRonacher, Katharinaen_ZA
dc.contributor.authorLelia Riza, Ancaen_ZA
dc.contributor.authorKoesoemadinata, Raspati C.en_ZA
dc.contributor.authorMalherbe, Stephanus T.en_ZA
dc.contributor.authorCioboata, Ramonaen_ZA
dc.contributor.authorLlontop, Juan Carlosen_ZA
dc.contributor.authorKleynhans, Leanieen_ZA
dc.contributor.authorLopez, Soniaen_ZA
dc.contributor.authorSantoso, Prayudien_ZA
dc.contributor.authorMarius, Cionteaen_ZA
dc.contributor.authorVillaizan, Katerineen_ZA
dc.contributor.authorRuslami, Rovinaen_ZA
dc.contributor.authorWalzl, Gerharden_ZA
dc.contributor.authorPanduru, Nicolae Mirceaen_ZA
dc.contributor.authorDockrell, Hazel M.en_ZA
dc.contributor.authorHill, Philip C.en_ZA
dc.contributor.authorAllister, Susan Mcen_ZA
dc.contributor.authorPearson, Fionaen_ZA
dc.contributor.authorMoore, David A. J.en_ZA
dc.contributor.authorCritchley, Julia A.en_ZA
dc.contributor.authorvan Crevel, Reinouten_ZA
dc.date.accessioned2022-06-02T06:32:52Zen_ZA
dc.date.available2022-06-02T06:32:52Zen_ZA
dc.date.issued2019-04en_ZA
dc.descriptionCITATION: Ugarte-Gil, C. et al. 2020. Diabetes mellitus among pulmonary tuberculosis patients from 4 Tuberculosis-endemic Countries: The TANDEM Study. Clinical infectious diseases, 70(5):780–788. doi:10.1093/cid/ciz284en_ZA
dc.descriptionThe original publication is available at https://academic.oup.com/cid/en_ZA
dc.description.abstractBackground Diabetes mellitus (DM) increases active tuberculosis (TB) risk and worsens TB outcomes, jeopardizing TB control especially in TB-endemic countries with rising DM prevalence rates. We assessed DM status and clinical correlates in TB patients across settings in Indonesia, Peru, Romania, and South Africa. Methods Age-adjusted DM prevalence was estimated using laboratory glycated hemoglobin (HbA1c) or fasting plasma glucose in TB patients. Detailed and standardized sociodemographic, anthropometric, and clinical measurements were made. Characteristics of TB patients with or without DM were compared using multilevel mixed-effect regression models with robust standard errors. Results Of 2185 TB patients (median age 36.6 years, 61.2% male, 3.8% human immunodeficiency virus–infected), 12.5% (267/2128) had DM, one third of whom were newly diagnosed. Age-standardized DM prevalence ranged from 10.9% (South Africa) to 19.7% (Indonesia). Median HbA1c in TB–DM patients ranged from 7.4% (Romania) to 11.3% (Indonesia). Compared to those without DM, TB–DM patients were older and had a higher body mass index (BMI) (P value < .05). Compared to those with newly diagnosed DM, TB patients with diagnosed DM had higher BMI and HbA1c, less severe TB, and more frequent comorbidities, DM complications, and hypertension (P value < .05). Conclusions We show that DM prevalence and clinical characteristics of TB–DM vary across settings. Diabetes is primarily known but untreated, hyperglycemia is often severe, and many patients with TB–DM have significant cardiovascular disease risk and severe TB. This underlines the need to improve strategies for better clinical management of combined TB and DM.en_ZA
dc.description.urihttps://academic.oup.com/cid/article/70/5/780/5431210?login=trueen_ZA
dc.description.versionPublishers versionen_ZA
dc.format.extent9 pagesen_ZA
dc.identifier.citationUgarte-Gil, C. et al. 2020. Diabetes mellitus among pulmonary tuberculosis patients from 4 Tuberculosis-endemic Countries: The TANDEM Study. Clinical infectious diseases, 70(5):780–788. doi:10.1093/cid/ciz284en_ZA
dc.identifier.issn1537-6591 (online)en_ZA
dc.identifier.issn1058-4838 (print)en_ZA
dc.identifier.otherdoi:10.1093/cid/ciz284en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/125301en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherOxford University Pressen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectTuberculosisen_ZA
dc.subjectDiabetesen_ZA
dc.subjectSyndemicen_ZA
dc.subjectCommunicable diseasesen_ZA
dc.subjectGlycosylated hemoglobinen_ZA
dc.titleDiabetes mellitus among pulmonary tuberculosis patients from 4 tuberculosis-endemic countries : the TANDEM studyen_ZA
dc.typeArticleen_ZA
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