Abstract
Objectives: Whether diabetes mellitus (DM) increases tuberculosis (TB) recurrence risk is debatable. We determined the effect of DM on TB recurrence. Methods: This retrospective nationwide cohort study included patients with TB who successfully completed TB treatment during 2011-2017 and were followed up for TB recurrence until August 2020. We performed subdistribution hazard model analyses stratified by sex to assess DM risk related to TB recurrence after successful treatment. Results: Of 199,571 participants who had received successful TB treatment, 47,952 (24%) had DM. There were more men (64.4%), positive acid-fast bacilli smears (35.9%), and positive cultures (49.5%) in the DM group. There were 6208 (3.1%) TB recurrences during 5.1 years of follow-up: 38.9% and 26.6% occurred 1 and 1-2 years after treatment completion, respectively. The recurrence rate was higher in the DM group (3.8%) than in the non-DM group (2.9%, P <0.0001). DM was associated with a higher TB recurrence risk, especially in men (adjusted hazard ratio 1.23, 95% confidence interval 1.15-1.32) but not in women (adjusted hazard ratio 0.96, 95% confidence interval 0.85-1.09). Conclusion: The TB recurrence rate after successful treatment was higher in patients with DM than in patients without DM. DM is associated with TB recurrence in men.
| Original language | English |
|---|---|
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | International Journal of Infectious Diseases |
| Volume | 127 |
| DOIs | |
| Publication status | Published - 2023 Feb |
Bibliographical note
Funding Information:This study used the National Health Information Database (NHIS-2019-1-662) of the National Health Insurance Service. This study was supported by grants from the National Evidence-based Healthcare Collaborating Agency funded by the Ministry of Health and Welfare (grant nos. NC19-002, NC20- 003, and NC21-001), a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C1235), and an intramural research grant from the Korean National Tuberculosis Association. The funding organizations played no role in the design of the study, choice of enrolled patients, review and interpretation of data, preparation of the manuscript, or final approval of the manuscript.
Funding Information:
The authors have no competing interests to declare. This study used the National Health Information Database (NHIS-2019-1-662) of the National Health Insurance Service. This study was supported by grants from the National Evidence-based Healthcare Collaborating Agency funded by the Ministry of Health and Welfare (grant nos. NC19-002, NC20- 003, and NC21-001), a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C1235), and an intramural research grant from the Korean National Tuberculosis Association. The funding organizations played no role in the design of the study, choice of enrolled patients, review and interpretation of data, preparation of the manuscript, or final approval of the manuscript. The study protocol was reviewed and approved by the institutional review board of the National Evidence-Based Healthcare Collaborating Agency (NECAIRB19-008-1). The requirement for written informed consent was waived due to the retrospective nature of the study using public deidentified data. DE contributed to interpretation, initial drafting of the manuscript, manuscript review and revision, and final approval of the version to be submitted. DJ participated in the design of the study, performed the data analysis and interpretation, and revised the manuscript. JM, DJ, HYK, HJK, and HSK contributed to interpretation and critically reviewed the manuscript for important intellectual content. HC and YAK conceptualized and designed the study, acquired and interpreted the data, reviewed and revised the manuscript, funding acquisition, and final approval of the version to be submitted.
Publisher Copyright:
© 2022 The Author(s)
All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases
