Volume 79, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Although type 2 diabetes (DM) is a recognized risk factor for development of tuberculosis (TB), the impact on treatment is unclear. Among the few published reports, some suggest that mycobacterial clearance during treatment is delayed in TB patients with DM. Using survival analysis on data from 469 culture-positive TB patients retrospectively identified in south Texas, we found DM to be an independent risk factor for a 5-day delay in mycobacterial clearance within the first 60 days of treatment.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Wild S, Roglic G, Green A, Sicree R, King H, 2004. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27 : 1047–1053. [Google Scholar]
  2. Oscarsson N, Silwer H, 1958. Incidence of pulmonary tuberculosis among diabetics. Acta Med Scand 160 (Suppl 335): 23–48. [Google Scholar]
  3. Ponce-De-Leon A, Garcia-Garcia Md ML, Garcia-Sancho MC, Gomez-Perez FJ, Valdespino-Gomez JL, Olaiz-Fernandez G, Rogas R, Ferreyra-Reyes L, Cano-Arellano B, Bobadilla M, Small PM, Sifuentes-Osornia J, 2004. Tuberculosis and diabetes in southern Mexico. Diabetes Care 27 : 1584–1590. [Google Scholar]
  4. Alisjahbana B, van CR, Sahiratmadja E, den HM, Maya A, Istriana E, Danusantoso H, Ottenhoff TH, Nelwan RH, van der Meer JW, 2006. Diabetes mellitus is strongly associated with tuberculosis in Indonesia. Int J Tuberc Lung Dis 10 : 696–700. [Google Scholar]
  5. Coker R, McKee M, Atun R, Dimitrova B, Dodonova E, Kuznetsov S, Drobniewski F, 2006. Risk factors for pulmonary tuberculosis in Russia: case-control study. BMJ 332 : 85–87. [Google Scholar]
  6. Shetty N, Shemko M, Vaz M, D’Souza G, 2006. An epidemiological evaluation of risk factors for tuberculosis in South India: a matched case control study. Int J Tuberc Lung Dis 10 : 80–86. [Google Scholar]
  7. Restrepo BI, Fisher-Hoch SP, Crespo JG, Whitney E, Perez A, Smith B, McCormick JB, 2006. Type 2 diabetes and tuberculosis in a dynamic bi-national border population. Epidemiol Infect 135 : 1–9. [Google Scholar]
  8. Singla R, Khan N, Al-Sharif N, Ai-Sayegh MO, Shaikh MA, Osman MM, 2006. Influence of diabetes on manifestations and treatment outcome of pulmonary TB patients. Int J Tuberc Lung Dis 10 : 74–79. [Google Scholar]
  9. Wang JY, Lee LN, Hsueh PR, 2005. Factors changing the manifestation of pulmonary tuberculosis. Int J Tuberc Lung Dis 9 : 777–783. [Google Scholar]
  10. Bacakoglu F, Basoglu OO, Cok G, Sayiner A, Ates M, 2001. Pulmonary tuberculosis in patients with diabetes mellitus. Respiration (Herrlisheim) 68 : 595–600. [Google Scholar]
  11. Perez-Guzman C, Torres-Cruz A, Villarreal-Velarde H, Vargas MH, 2000. Progressive age-related changes in pulmonary tuberculosis images and the effect of diabetes. Am J Respir Crit Care Med 162 : 1738–1740. [Google Scholar]
  12. Lee KM, Choe KH, Kim SJ, 2006. Clinical investigation of cavitary tuberculosis and tuberculous pneumonia. Korean J Intern Med 21 : 230–235. [Google Scholar]
  13. Kaplan EL, Meier P, 1956. Nonparametric estimation from incomplete observations. J Am Stat Assoc 53 : 457–481. [Google Scholar]
  14. Cox DR, Oakes D. Analysis of Survival Data. London: Chapman and Hall; 1984.
  15. American Thoracic Society, Infectious Diseases Society of America, Centers for Disease Control and Prevention, 2003. Treatment of tuberculosis. MMWR 20 : 1–77. [Google Scholar]
  16. Riley RL, Mills CC, Nyka W, Weinstock N, Storey PB, Sultan LU, Riley MC, Wells WF, 1959. Aerial dissemination of pulmonary tuberculosis. A two-year study of contagion in a tuberculosis ward. Am J Epidemiol 142 : 3–14. [Google Scholar]
  17. Ahmad D, Morgan WK, 2000. How long are TB patients infectious? CMAJ 25 : 157–158. [Google Scholar]
  18. Cantor AB, Krischer JP, Cuthbertson DD, Schatz DA, Riley WJ, Malone J, Schwartz S, Quattrin T, Maclaren NK, 1995. Age and family relationship accentuate the risk of insulin-dependent diabetes mellitus (IDDM) in relatives of patients with IDDM. J Clin Endocrinol Metab 80 : 3739–3743. [Google Scholar]
  19. O’Rahilly S, Barroso I, Wareham NJ, 2005. Genetic factors in type 2 diabetes: the end of the beginning? Science 307 : 370–373. [Google Scholar]
  20. Hallman DM, Boerwinkle E, Gonzalez VH, Klein BE, Klein R, Hanis CL, 2007. A genome-wide linkage scan for diabetic retinopathy susceptibility genes in Mexican Americans with type 2 diabetes from Starr County, Texas. Diabetes 56 : 1167–1173. [Google Scholar]
  21. Guler M, Unsal E, Dursun B, Aydln O, Capan N, 2007. Factors influencing sputum smear and culture conversion time among patients with new case pulmonary tuberculosis. Int J Clin Pract 61 : 231–235. [Google Scholar]
  22. American Thoracic Society, 2000. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 161: 1376–1395. [Google Scholar]
  23. Martens GW, Arikan MC, Lee J, Ren F, Greiner D, Kornfeld H, 2007. Tuberculosis susceptibility of diabetic mice. Am J Respir Cell Mol Biol 37 : 518–524. [Google Scholar]
  24. Stalenhoef JE, Alisjahbana B, Nelwan EJ, Vand V, Ottenhoff TH, Vandermeer JW, Nelwan RH, Netea MG, Vancrevel R, 2007. The role of interferon-gamma in the increased tuberculosis risk in type 2 diabetes mellitus. Eur J Clin Microbiol Infect Dis 27 : 97–103. [Google Scholar]
  25. Tsukaguchi K, Yoneda T, Okamura H, Tamaki S, Takenaka H, Okamoto Y, Narita N, 2000. Defective T cell function for inhibition of growth of Mycobacterium avium-intracellulare complex (MAC) in patients with MAC disease: restoration by cytokines. J Infect Dis 182 : 1664–1671. [Google Scholar]
  26. Nijland HM, Ruslami R, Stalenhoef JE, Nelwan EJ, Alisjahbana B, Nelwan RH, van der V, Danusantoso H, Aarnoutse RE, van Crevel R, 2006. Exposure to rifampicin is strongly reduced in patients with tuberculosis and type 2 diabetes. Clin Infect Dis 43 : 848–854. [Google Scholar]
  27. Dye C, 2006. Global epidemiology of tuberculosis. Lancet 367 : 938–940. [Google Scholar]

Data & Media loading...

  • Received : 13 Nov 2007
  • Accepted : 26 Jun 2008

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error