Diabetes mellitus in patients with pulmonary tuberculosis in an aging population in Shanghai, China: Prevalence, clinical characteristics and outcomes

Aims: To determine the prevalence of diabetes mellitus among pulmonary tuberculosis patients and the difference of clinical characteristics and outcomes between pulmonary tuberculosis patients with and without diabetes mellitus in an aging population in Shanghai, China. Methods: This is a retrospective population-based study. 201 newly diagnosed pulmonary tuberculosis patients in Changning District, Shanghai during 2007-2008 were included. Clinical characteristics and outcomes were collected. Determination of diabetes mellitus was based on the medical records before pulmonary tuberculosis was diagnosed. Results: The prevalence of diabetes mellitus among pulmonary tuberculosis patients was 19.9% (40/201). Pulmonary tuberculosis patients with diabetes mellitus were more likely to be old (>= 50, OR = 5.23, 95% CI = 2.07-13.25), to have pulmonary cavities (OR = 3.02, 95% CI = 1.31-6.98), to be sputum smear positive (OR = 2.90, 95% CI = 1.12-7.51), and to have extension of anti-tuberculosis treatment duration (OR = 2.68, 95% CI 1.17-6.14). Besides, they had a higher 2nd month sputum smear positive proportion (OR = 2.97, 95% CI 1.22-7.22) and a higher 5-year recurrence rate (OR = 5.87, 95% CI 1.26-27.40). Conclusions: High prevalence, severe clinical characteristics and poor outcomes of pulmonary tuberculosis patients with diabetes mellitus highlight the necessity of early bi-directional screening and co-management of these two diseases in Shanghai, China. (C) 2016 Elsevier Inc. All rights reserved.