Stress Hyperglycemia in Patients with Tuberculosis Disease: Epidemiology and Clinical Implications

• Type of Material: Article
• Authors: Matthew James Magee, Emory University; Argita D. Salindri, Georgia State University; Thu Thu Kyaw Nang, Georgia State University; Sara Auld, Emory University; J. Sonya Haw, Emory University; Guillermo Umpierrez, Emory University
• Language: English
• Date: 2018-09-01
• Publisher: Springer (part of Springer Nature): Springer Open Choice Hybrid Journals
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
• Final Published Version (URL): http://dx.doi.org/10.1007/s11892-018-1036-y
• Title of Journal or Parent Work: Current Diabetes Reports
• ISSN: 1534-4827
• Volume: 18
• Issue: 9
• Start Page: 71
• End Page: 71
• Grant/Funding Information: This publication was supported by the National Institute Of Allergy And Infectious Diseases of the National Institutes of Health under Award Numbers R03AI133172 (Magee) and K23AI134182 (Auld).
• Keywords: PULMONARY TUBERCULOSIS; HOSPITAL MORTALITY; ASSOCIATION; Infection; INSULIN-RESISTANCE; Stress hyperglycemia; Tuberculosis; Endocrinology & Metabolism; TYPE-2 DIABETES-MELLITUS; GLUCOSE-METABOLISM; Science & Technology; RESEARCH AGENDA; RISK-FACTORS; Life Sciences & Biomedicine; PREVALENCE; TREATMENT OUTCOMES
• Research Categories: Health Sciences, Public Health; Health Sciences, Medicine and Surgery; Health Sciences, Epidemiology

Abstract

Purpose of Review: The intersection of tuberculosis (TB) disease and type 2 diabetes mellitus is severely hindering global efforts to reduce TB burdens. Diabetes increases the risk of developing TB disease and negatively impacts TB treatment outcomes including culture conversion time, mortality risk, and TB relapse. Recent evidence also indicates plausible mechanisms by which TB disease may influence the pathogenesis and incidence of diabetes. We review the epidemiology of stress hyperglycemia in patients with TB and the pathophysiologic responses to TB disease that are related to established mechanisms of stress hyperglycemia. We also consider clinical implications of stress hyperglycemia on TB treatment, and the role of TB disease on risk of diabetes post-TB. Recent Findings: Among patients with TB disease, the development of stress hyperglycemia may influence the clinical manifestation and treatment response of some patients and can complicate diabetes diagnosis. Summary: Research is needed to elucidate the relationship between TB disease and stress hyperglycemia and determine the extent to which stress hyperglycemia impacts TB treatment response. Currently, there is insufficient data to support clinical recommendations for glucose control among patients with TB disease, representing a major barrier for efforts to improve treatment outcomes for patients with TB and diabetes.