Evaluation of an intermittent six-month regimen in new pulmonary tuberculosis patients with diabetes mellitus.

Balasubramanian, R.; Ramanathan, U.; Thyagarajan, K.; Ramachandran, R.; Rajaram, K.; Bhaskar, D.; Shantharam; Hariharan, R.S.; Narayanan, P.R.

Indian Journal of Tuberculosis; 2007; 54; 168-176.

Summary: Background: The treatment of tuberculosis (TB) with category I regimen of the Revised National Tuberculosis Control Programme (RNTCP) for patients with diabetes mellitus (DM) needs evaluation.

Objective: To assess the cure and relapse rates in 3 years, among the new smear-positive TB patients with Type-2 DM (DMTB) treated with CAT-I regimen (2E 3 ,H 3 ,R 3 ,Z 3 /4R 3 H 3 ) of RNTCP.

Methodology: TB suspects attending the diabetology units and the TB research centre (TRC), Chennai, were investigated. Eligible DMTB cases were enrolled. Baseline estimation of cardiac, renal, liver function tests and glycosylated-HBA1c were undertaken. All patients received 2E 3 ,H 3 ,R 3 ,Z 3 /4R 3 H 3 under supervision at TRC. Clinical and sputum (smear and culture) examinations and monitoring of diabetic status were undertaken every month upto 24 months, then once in 3 months upto 36 months.

Results: Of 100 patients admitted, 7 were excluded for various reasons from analysis. Of 93 patients, 87 (94%) had a favourable response at the end of treatment. Pre and post treatment mean glycosylated-HBAIc were 9.7% amd 8.4% (>7% poor control). During follow-up period, 6 died and one lost to follow-up. Of the remaining, four relapsed.

Conclusion: Category-I regimen, recommended for all the new smear-positive patients in the Indian TB programme, is effective in the treatment of DMTB patients, despite poor control of diabetes.

Keywords: Treatment of TB paitents with diabetes melitus, Type-2 diabetes melitus.

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