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

  • Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)
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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.

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Funding

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). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, PO Box 3984, Atlanta, GA, 30302-3984, USA

    Matthew J. Magee, Argita D. Salindri & Nang Thu Thu Kyaw

  2. Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union) Office, Mandalay, Myanmar

    Nang Thu Thu Kyaw

  3. Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine and Rollins School of Public Health, 615 Michael St, NE Ste 205 , Atlanta, GA, 30322, USA

    Sara C. Auld

  4. Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, 69 Jesse Hill Jr Dr SE, Glenn Memorial Building, Atlanta, GA, 30303, USA

    J. Sonya Haw & Guillermo E. Umpierrez

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  1. Matthew J. Magee
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  2. Argita D. Salindri
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  3. Nang Thu Thu Kyaw
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  4. Sara C. Auld
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Correspondence to Matthew J. Magee.

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Matthew J. Magee, Argita D. Salindri, Nang Thu Thu Kyaw, Sara C. Auld, J. Sonya Haw, and Guillermo E. Umpierrez declare they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Other Forms of Diabetes and Its Complications

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Magee, M.J., Salindri, A.D., Kyaw, N.T.T. et al. Stress Hyperglycemia in Patients with Tuberculosis Disease: Epidemiology and Clinical Implications. Curr Diab Rep 18, 71 (2018). https://doi.org/10.1007/s11892-018-1036-y

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