1657. Characteristics and Treatment Outcomes of Tuberculosis in Patients with Diabetes Mellitus--  California, 2010
Session: Poster Abstract Session: Mycobacterial Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: More than 20% of patients with tuberculosis (TB) disease also have diabetes mellitus (DM). We sought to determine whether diabetic patients with TB in California have more extensive TB disease and worse treatment outcomes than patients without DM. 

Methods: We analyzed California Department of Public Health TB Registry data for patients reported with TB during 2010.  Demographic, clinical and treatment characteristics of TB patients with DM were compared to those without DM by using chi square tests for categorical variables and Wilcoxon rank-sum tests for continuous variables.

Results: Of 2326 patients with TB, 485 (21%) also had DM.  Compared to TB patients without DM, TB-DM patients were more likely: male (65% vs. 58%, 0=0.005); older (median age=62 vs. 45 years, p<0.0001); Asian (53% vs. 47%, p=0.012); foreign-born (88% vs. 76%, p<0.0001); to have had end-stage renal disease (9% vs. 2%, p<0.0001); to have had pulmonary involvement (84% vs. 77%, p=0.001); and to have presented for care with TB symptoms (72% vs. 61%, p<0.0001).  Among patients with pulmonary TB, patients with DM were more likely to have had: sputum cultures performed (94% vs. 91%, p=0.018); computed tomography (CT) scans (57% vs. 44%, p<0.0001); acid fast bacilli (AFB) smear-positive sputum (65% vs. 49%, p<0.0001); positive sputum cultures (86% vs. 80%, p=0.0077); cavities on chest radiograph (30% vs. 18%, p<0.0001); and cavities on CT scan (55% vs. 33%, p<0.0001).  Compared to TB patients without DM, a greater percentage of TB-DM patients died during anti-TB therapy (12% vs. 5%, p<0.0001).  When stratified by age, TB patients less than 62 years were more likely to die if they had DM than TB patients without DM (5% vs. 2%, p=0.01), but percentages of deaths among patients 62 years old and older with DM vs. without DM did not differ (19% vs. 16%, p=0.34).

Conclusion: In California, TB patients with DM had more extensive disease and were more likely to be infectious, and, among younger persons, were more likely to die on TB treatment.  Efforts to prevent TB and to identify TB early among patients with diabetes may prevent deaths and improve TB control in California

Lisa Pascopella, PhD, MPH and Pennan Barry, MD, MPH, Tuberculosis Control Branch, California Department of Public Health, Richmond, CA

Disclosures:

L. Pascopella, None

P. Barry, None

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