# Impact of hyperglycemia on tuberculosis treatment outcomes: a cohort study

## TL;DR

This study found that hyperglycemia worsens tuberculosis treatment outcomes by increasing symptoms and complications.

## Contribution

The study identifies hyperglycemia as a risk factor for severe TB symptoms and gastrointestinal side effects during treatment.

## Key findings

- Hyperglycemia increases the risk of elevated TB scores, cough, and night sweats.
- Hyperglycemia is linked to more positive sputum smears and gastrointestinal issues like vomiting and constipation.
- Hyperglycemia does not affect pulmonary lesions as seen in CT scans.

## Abstract

Hyperglycemia is prevalent and closely associated with pulmonary tuberculosis (PTB). This study aimed to investigate the effects of hyperglycemia on the outcomes of PTB treatment. This study comprised 791 patients with PTB in total. Patients with fasting plasma glucose levels of ≥ 6.1 mmol/L were diagnosed with hyperglycemia. Anthropometric and baseline demographic data were also collected. The treatment response was assessed based on clinical symptoms (sputum production, cough, chest pain, fever, hemoptysis, night sweats, loss of appetite, and fatigue), sputum smear, chest computed tomography (CT), and adverse gastrointestinal responses (vomiting, nausea, abdominal distension, diarrhea, and constipation). A generalized estimating equation (GEE) was used to evaluate these relationships. Hyperglycemia affected 266 (33.6%) of the 791 patients with PTB. In GEE analyses, patients with hyperglycemia exhibited a greater incidence of elevated tuberculosis (TB) scores (odds ratio (OR) 1.569; 95% CI 1.040–2.369), cough (OR 1.332; 95% CI 1.050–1.690), and night sweats (OR 1.694; 95% CI 1.288–2.335). Hyperglycemia was linked with a higher risk of positive sputum smears (OR 1.941; 95% CI 1.382–2.727). During therapy, hyperglycemia was also associated with an increased incidence of vomiting (OR 2.738; 95% CI 1.041–7.198), abdominal distension (OR 2.230; 95% CI 1.193–4.171), and constipation (OR 2.372; 95% CI 1.442–3.902). However, the CT results indicated that hyperglycemia did not affect pulmonary lesions in patients with TB. Patients with TB and hyperglycemia are at a higher risk of severe clinical manifestations, positive sputum smears, and adverse gastrointestinal effects and, therefore, the special situation of hyperglycemic patients should be considered in the prevention and treatment of TB.