Glycated haemoglobin levels in patients with multidrug-resistant tuberculosis infection during 6 months of treatment

Abstract

Background: There is little information on the possible impact of drugs used in the treatment of  multi-drug resistant tuberculosis (MDR-TB) on glycaemic levels. This study therefore assessed changes in glycated haemoglobin levels in patients with MDR-TB.
Materials and Methods: This longitudinal study involved 21 MDR-TB patients who were followed up for 6 months. Glycated haemoglobin (HbA1c) level of each patient was determined before the  commencement of MDR-TB drug regimen and at 2, 4 and 6 months post treatment as part of a study which investigated them every 2 months. Differences in means were assessed using the paired Student’s t-test and statistical significance was set at P<0.05.
Results: A patient had undiagnosed diabetes mellitus (DM) with an HbA1c value of 6.5% and died before the second month sample collection; another patient became critically ill; therefore, 19 patients completed the study. Before the commencement of MDR-TB therapy, two patients had pre-diabetes with HbA1c values of 6.0% and 5.8% while the HbA1c values of the remaining patients were less than 5.7%. There was a significant reduction in the mean HbA1c level at 2 months post therapy compared with the baseline. However, the HbA1c levels increased slightly after the 2nd month of therapy but no significant change was observed in the HbA1c levels at 4 and 6 months of MDR-TB therapy compared with baseline.
Conclusion: Diabetes mellitus is not common among Nigerians with MDR-TB and MDR-TB drug  regimen might have an acute effect on glycaemic changes in patients with MDR-TB.

Keywords: Diabetes mellitus, Glycaemic change, Glycated haemoglobin, Multidrug resistant tuberculosis therapy