Differentiating transient from persistent diabetic range hyperglycemia in a cohort of people completing tuberculosis treatment in Dhaka, Bangladesh.

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  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Diabetes Mellitus/*diagnosis ; Hyperglycemia/*diagnosis ; Prediabetic State/*diagnosis ; Tuberculosis/*complications; Adolescent ; Adult ; Bangladesh/epidemiology ; Diabetes Mellitus/blood ; Diabetes Mellitus/epidemiology ; Disease Management ; Female ; Glycated Hemoglobin/analysis ; Humans ; Hyperglycemia/blood ; Hyperglycemia/epidemiology ; Male ; Middle Aged ; Prediabetic State/blood ; Prediabetic State/epidemiology ; Prospective Studies ; Risk Factors ; Tuberculosis/diagnosis ; Tuberculosis/therapy ; Young Adult
    • Abstract:
      Background: In recent non-pandemic periods, tuberculosis (TB) has been the leading killer worldwide from a single infectious disease. Patients with DM are three times more likely to develop active TB and poor treatment outcomes. Single glycemic measurements at TB diagnosis may inaccurately diagnose or mischaracterize DM severity. Data are limited regarding glycemic dynamics from TB diagnosis through treatment.
      Methods: Prospective study of glycemia dynamics in response to TB treatment measured glycosylated haemoglobin (HbA1c) in patients presenting to TB screening centres in Bangladesh to determine the prevalence and risk factors of hyperglycemia before and at TB treatment completion.
      Results: 429 adults with active TB disease were enrolled and divided into groups based on history of DM and initial HbA1c range: normoglycemia, prediabetes, and DM. DM was diagnosed in 37%. At treatment completion,14(6%) patients from the normoglycemia and prediabetes groups had HbA1c>6.5%, thus increasing the prevalence of DM to 39%. The number needed to screen to diagnose one new case of DM at TB diagnosis was 5.7 and 16 at treatment completion in the groups without DM. Weight gain>5% at treatment completion significantly increased the risk of hyperglycemia in the groups without DM at TB diagnosis (95% CI 1.23-26.04, p<0.05).
      Conclusion: HbA1c testing prior to and at TB treatment completion found a high prevalence of prediabetes and DM, including a proportion found at treatment completion and commonly in people with a higher percentage of weight gain. Further longitudinal research is needed to understand the effects of TB disease and treatment on insulin resistance and DM complications.
      Competing Interests: The authors have declared that no competing interests exist.
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    • Grant Information:
      T32 AI007046 United States AI NIAID NIH HHS
    • Accession Number:
      0 (Glycated Hemoglobin A)
      0 (hemoglobin A1c protein, human)
    • Publication Date:
      Date Created: 20211123 Date Completed: 20220104 Latest Revision: 20240404
    • Publication Date:
      20240404
    • Accession Number:
      PMC8610235
    • Accession Number:
      10.1371/journal.pone.0260389
    • Accession Number:
      34813631