The negative clinical impact of diabetes on tuberculosis: A cross-sectional study in New Jersey

Abstract

Context: Numerous studies have investigated a link between tuberculosis (TB) and type 2 diabetes mellitus (DM) in high-incidence countries. There is a need to characterize the relationship of TB andDM in the United States. Objective: To characterize the clinical and demographic differences in patients with TB with and without DM. Design: Cross-sectional. Setting: This study was performed at an institutional center providing TB care for New Jersey. Patients or Other Participants: A total of 353 cases of TB were seen at the Lattimore Clinic between 2009 and 2014. After excluding those with HIV infection and those under 19 years of age, 73 cases of TB were reviewed. Intervention(s): No interventions performed. Main Outcome Measure(s): Sputum culture positivity, time to culture conversion, extent of disease on chest x-ray, and degree of cavitation on chest x-ray. Outcome measures were determined prior to data collection. Results: Extent of disease on chest x-ray was higher for DM1 cases compared with DM2 cases (P = 0.007). A total of 24% of DM1 cases had evidence of cavitation on chest x-ray compared with 5% of DM2 cases (P = 0.03). DM1 cases were slightly more likely to have positive sputum cultures than were DM2 cases (P = 0.07). The median time to sputum culture conversion was 27.5 days in the DM+ group vs 18.0 days in the DM2 group (P = 0.26). Conclusions: Extent of disease on chest x-ray was significantly more severe in the DM1 group than in the DM2 group.