The impact of diabetes mellitus on the emergence of multi-drug resistant tuberculosis and treatment failure in TB-diabetes comorbid patients: a systematic review and meta-analysis

• Main Authors: Anees ur Rehman (Author), Mahnoor Khattak (Author), Usman Mushtaq (Author), Muhammad Latif (Author), Imran Ahmad (Author), Muhammad Fawad Rasool (Author), Sadia Shakeel (Author), Khezar Hayat (Author), Rabia Hussain (Author), Ghaidaa Ali Alhazmi (Author), Afnan Owedah Alshomrani (Author), Mohammed Ibrahim Alalawi (Author), Saleh Alghamdi (Author), Mohammad Tarique Imam (Author), Safa S. Almarzoky Abuhussain (Author), Sarah M. Khayyat (Author), Abdul Haseeb (Author)
• Format: Book
• Published: Frontiers Media S.A., 2023-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2296-2565; 10.3389/fpubh.2023.1244450
• Keywords: tuberculosis; diabetes mellitus; TB-DM comorbidity; multi-drug resistant TB; treatment failure; disease progression; Public aspects of medicine; RA1-1270
• Source: Frontiers in Public Health, Vol 11 (2023)

BackgroundThe existence of Type 2 Diabetes Mellitus (DM) in tuberculosis (TB) patients is very dangerous for the health of patients. One of the major concerns is the emergence of MDR-TB in such patients. It is suspected that the development of MDR-TB further worsens the treatment outcomes of TB such as treatment failure and thus, causes disease progression.AimTo investigate the impact of DM on the Emergence of MDR-TB and Treatment Failure in TB-DM comorbid patients.MethodologyThe PubMed database was systematically searched until April 03, 2022 (date last searched). Thirty studies met the inclusion criteria and were included in this study after a proper selection process.ResultsTuberculosis-Diabetes Mellitus patients were at higher risk to develop MDR-TB as compared to TB-non-DM patients (HR 0.81, 95% CI: 0.60-0.96, p < 0.001). Heterogeneity observed among included studies was moderate (I2 = 38%). No significant change was observed in the results after sub-group analysis by study design (HR 0.81, 95% CI: 0.61-0.96, p < 0.000). In the case of treatment failure, TB-DM patients were at higher risk to experience treatment failure rates as compared to TB-non-DM patients (HR 0.46, 95% CI: 0.27-0.67, p < 0.001).ConclusionThe results showed that DM had a significant impact on the emergence of MDR-TB in TB-diabetes comorbid patients as compared to TB-non-DM patients. DM enhanced the risk of TB treatment failure rates in TB-diabetes patients as compared to TB-non-DM patients. Our study highlights the need for earlier screening of MDR-TB, thorough MDR-TB monitoring, and designing proper and effective treatment strategies to prevent disease progression.