Is resistance to anti-tuberculosis drugs associated with type 2 diabetes mellitus? A register review in Beijing, China

Abstract

Background: China has a high burden of drug-resistant tuberculosis (TB) and diabetes mellitus (DM). Objective: The objectives of this study were to determine the following in patients with culture-confirmed TB: 1) demographic characteristics and disease patterns in relation to the presence or absence of type 2 diabetes and 2) presence or absence of drug resistance to isoniazid (INH), rifampicin (RMP) or both in relation to duration of diabetes and control of diabetes. Design: This is a cross-sectional and retrospective study involving record reviews. Results: There were 621 patients with culture-positive TB, of whom 187 (30%) had previously known or new type 2 diabetes. In those with diabetes, there was a significantly higher proportion of males, persons aged ≥35 years and patients registered with new TB (p<0.05). Prevalence of multidrug-resistant TB (MDR-TB) was 6.2% in new patients (N=422) and 62.3% in previously treated patients (N=199), with no significant differences between those with and without diabetes. In patients with diabetes, there was no association of drug resistance with diabetes duration or disease control [assessed by fasting blood glucose (FBG) at 1 week]. Conclusion: A high proportion of patients with TB in a tertiary health facility, Beijing, China, had diabetes, but there was no association between type 2 diabetes and drug-resistant TB. Further prospective studies are needed to confirm these findings.