Tuberculosis Complicated by Diabetes Mellitus at Shanghai Pulmonary Hospital, China

An association between diabetes mellitus (DM) and tuberculosis (TB) has been implied for a long time. We previously reported that KDP type 1 diabetic rats and GK type 2 diabetic rats are highly susceptible to Mycobacterium tuberculosis infection. As a next step, we conducted a retrospective analysis of 2,141 patients with pulmonary TB newly diagnosed during the period from 2008 to 2009 to evaluate the influence of DM on the drug response rate and the long-term relapse rate of TB. There were 203 DM patients with TB (type 1 DM, 7 [3.4%]; type 2 DM, 196 [96.6%]). The TB relapse rate (2 years after discharge) was higher in DM patients than in non-diabetic patients (20% versus 5.3%). The frequency of multidrug-resistant-TB among DM patients with TB was higher than that among TB patients (17.7% versus 8.4%, P < 0.01). These results suggest that the period of TB treatment should be prolonged, and that in the meantime the blood glucose level should be maintained within a reference value range.