Muhammad Mudusar Hassan, Adnan Zafar, Shahzad Akram.
Glycemic Control and Clinical Outcomes of Diabetic Pulmonary Tuberculosis patients.
Pak J Med Health Sci Jan ;12(1):371-4.

Aim : To investigate the role of glycemic control in clinical outcome of smear positive pulmonary tuberculosis patients who also had diabetes. Methods: This prospective multicenter study was conducted in Pulmonology Department of Sheikh Zayed Hospital , Rahim Yar Khan, Services Hospital, Lahore and Bahawal Victoria Hospital, Bahawalpur. From July 2014 to June 2016 after taking approval from ethical committee of the Hospital. Total 280 patients who also had diabetes were enrolled in study by non-probability consecutive sampling. They were divided in two groups. One group having good glycemic control (HbA 1C<7%) and second group having poor glycemic control (HbA1C>7%). Written permission was signed by each patient recruited in study. Quantitative variables like age, body mass index, smoking pack years, blood glucose level, glycosylated hemoglobin level and hemoglobin were statistically measured and analyzed in mean and standard deviation and t-test was applied to check the significance. Qualitative variables like gender, income, smoking status and glycemic control were statistically measured and analyzed in frequency and percentage and chi-square test was applied to check the significance. Results: Among total 280 patients on radiographic examination, cavitary lesions were noted in 136( 78.6% ) and 43( 40.2%) patients for PGC and OCG groups respectively. It was found that, cavitary lesions were more frequently occurred in patients with PGC. Therefore, the difference was statistically significant. (x2 =42.33, p=0.000). At the end of the intensive phase of therapy, majority of the patients i.e. , 87 (50.3%) with PGC remained smear-positive compared to OGC patients i.e. 13( 12.1%). This difference was statistically significant (x2 =41.88, p=0.000). As far as treatment outcome; 120( 69.4%) and 100( 93.5%) patients were observed as cured in PGC and OCG groups respectively. This difference was also statistically significant. (x2 =22.79, p=0.000). Conclusion: Poor glycemic control before treatment of pulmonary tuberculosis can be associated with poor clinical outcome in the form of lung cavitations and delayed sputum smear conversion. It is also associated with more relapse in tuberculosis.

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