Transient hyperglycemia tied to higher risk of unfavourable treatment outcome in pulmonary TB

Persistent euglycemia: HbA1c < 6.5% at baseline and three-month follow-up; Persistent hyperglycemia: HbA1c ≥ 6.5% at baseline and three-month follow-up; Transient hyperglycemia: HbA1c ≥ 6.5% at baseline and <6.5% at three-month follow-up; Incident hyperglycemia: HbA1c < 6.5% at baseline and ≥ 6.5% at three-month follow-up.

The association between HbA1c trajectories and unfavourable treatment outcomes of all-cause mortality, recurrence, and failure was measured using Multivariable Poisson regression.

The study led to the following findings:

• Of the 587 participants, 76% had persistent euglycemia, 20% had persistent hyperglycemia, and 4% had transient hyperglycemia.
• One participant had an incident of hyperglycemia and was excluded.
• Compared to participants with persistent euglycemia, those with transient hyperglycemia had a two-fold higher risk of experiencing an unfavourable treatment outcome (aIRR=2.07) after adjusting for confounders including diabetes treatment, and Body-Mass Index; a significant association with persistent hyperglycemia (aIRR=1.64) was not found.
• Diabetes treatment was associated with a significantly lower risk of unfavourable treatment outcomes (aIRR=0.38).

"Lack of diabetes treatment and transient hyperglycemia was associated with a higher risk of unfavourable treatment outcomes in adults with pulmonary tuberculosis," the researchers concluded.

Reference:

Pardeshi, G., Mave, V., Gaikwad, S., Kadam, D., Barthwal, M., Gupte, N., Atre, S., Deshmukh, S., Golub, J. E., & Gupte, A. (2023). Glycated Haemoglobin Trajectories and their Association with Treatment Outcomes among Pulmonary Tuberculosis Cases in India - A Prospective Cohort Study. CHEST. https://doi.org/10.1016/j.chest.2023.08.026