La tuberculose pulmonaire provoque un déséquilibre du diabète

Maâlej, S.; Belhaoui, N.; Bourguiba, M.; Mahouachi, R.; Chtourou, A.; Taktak, S.; Fennira, H.; Slim, L.; Kheder, A. Ben; Drira, I.

doi:10.1016/j.lpm.2008.05.011

Cited by 11 publications

(3 citation statements)

References 7 publications

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“…This observation corroborates that made by Maâlej and colleagues of a strong association between the imbalance of diabetes and the presence of a factor contributing to hyperglycaemia, in particular, pulmonary infection with a multiplication of the risk of occurrence of two to six times. 33 The infection represents stress to the body, and the stress response leads to the activation of the sympathetic system with the release of hyperglycaemic catecholamines. 28 Diabetes is increasing in importance in our settings with few resources for health and health systems directed to other priorities; working to achieve an adequate glycaemic control for diabetic patients through cost-effective interventions is crucial.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence and determinants of poor glycaemic control amongst patients with diabetes followed at Vanga Evangelical Hospital, Democratic Republic of the Congo

Cedrick

Lubaki

Francois

et al. 2021

African Journal of Primary Health Care & Family Medicine

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Democratic Republic of the Congo (DRC). 5 In Kinshasa, a study conducted in 2000 estimated the prevalence of diabetes to 7% in adults. 6 In Kisantu, a semi-urban area in the DRC, the prevalence of diabetes mellitus was estimated at 4.8% in 2007. 7 In Bukavu, Katchunga et al. reported a prevalence rate of 7.3% in 2012. 8 Background: The prevalence of diabetes mellitus is increasing dramatically in developing countries, where diabetic patients usually present with poor glycaemic control, leading to complications and worsening the prognosis. Aim:The aim of this study was to determine the extent of poor glycaemic control and its determinants in diabetic patients. Setting:The study was conducted in a rural area of the province of Kwilu, Democratic Republic of the Congo.Methods: This research comprised a cross-sectional study involving 300 Type 1 and 2 diabetic patients attending Vanga Evangelical Hospital in the Democratic Republic of the Congo from January 2018 to March 2018. Patients' sociodemographic, clinical and biological characteristics, accessibility to the health structure and treatment were described. The determinants of poor glycaemic control were identified using multivariate logistic regression at the p < 0.05 level of statistical significance. Results:The mean age of participants was 46.9 ± 16.3 years, 68.4% were men, and 62.3% had Type 2 diabetes mellitus. Poor glycaemic control was present in 78% of patients. The independent determinants of poor glycaemic control were tobacco use (adjusted odds ratio [aOR]: 2.01 [1.77-5.20], p = 0.015), the presence of comorbidities (aOR: 2.86 [1.95-6.65], p = 0.007), the presence of a factor contributing to hyperglycaemia (aOR: 2.74 [1.83-3.67], p = 0.014), missing scheduled appointments (aOR: 2.59 [1.94-7.13], p = 0.006) and non-adherence to treatment (aOR: 4.09 [1.35-6.39], p = 0.008). Conclusion:This study shows that more than three-quarters of diabetics undergoing treatment are not controlled, with mainly patient-related factors as the main explanatory factors for this poor glycaemic control. Therefore, the establishment of a therapeutic education programme and wider integration of diabetes care services, mainly at the primary level of the healthcare pyramid, should contribute to improved diabetes treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of poor glycaemic control amongst patients with diabetes followed at Vanga Evangelical Hospital, Democratic Republic of the Congo

Cedrick

Lubaki

Francois

et al. 2021

African Journal of Primary Health Care & Family Medicine

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show abstract

“…The time to culture conversion has been modestly delayed in other studies of diabetics when compared to non-diabetic controls likely related to a higher bacillary burden at presentation [5, 21, 22]. While our current study did not permit comparison of time to culture conversion in TB cases for whom TDM was not performed, the decreased total number of slow responders during the period of the early TDM initiative and the decreased proportion of diabetics that developed slow response compared to historical norms provide support that early correction of low drug concentrations may avert slow response in some diabetics.…”

Section: Discussionmentioning

confidence: 99%

Early Therapeutic Drug Monitoring for Isoniazid and Rifampin among Diabetics with Newly Diagnosed Tuberculosis in Virginia, USA

Heysell

Moore

Staley

et al. 2013

Tuberculosis Research and Treatment

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Slow responders to tuberculosis (TB) treatment in Virginia have prolonged treatment duration and consume more programmatic resources. Diabetes is an independent risk factor for slow response and low serum anti-TB drug concentrations. Thus, a statewide initiative of early therapeutic drug monitoring (TDM) for isoniazid and rifampin at 2 weeks after TB treatment was piloted for all diabetics with newly diagnosed TB. During the period of early TDM, 12/01/2011–12/31/2012, 21 diabetics had C 2 hr concentrations performed and 16 (76%) had a value below the expected range for isoniazid, rifampin, or both. Fifteen had follow-up concentrations after dose adjustment and 12 (80%) increased to within the expected range (including all for rifampin). Of 16 diabetic patients with pulmonary TB that had early TDM, 14 (88%) converted their sputum culture to negative in <2 months. Early TDM for diabetics was operationally feasible, may speed response to TB therapy, and can be considered for TB programs with high diabetes prevalence.

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The impact of diabetes on tuberculosis treatment outcomes: evidence based on a cumulative meta-analysis

Han

Wang

et al. 2016

Int J Diabetes Dev Ctries

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La tuberculose pulmonaire provoque un déséquilibre du diabète

Cited by 11 publications

References 7 publications

Prevalence and determinants of poor glycaemic control amongst patients with diabetes followed at Vanga Evangelical Hospital, Democratic Republic of the Congo

Prevalence and determinants of poor glycaemic control amongst patients with diabetes followed at Vanga Evangelical Hospital, Democratic Republic of the Congo

Early Therapeutic Drug Monitoring for Isoniazid and Rifampin among Diabetics with Newly Diagnosed Tuberculosis in Virginia, USA

The impact of diabetes on tuberculosis treatment outcomes: evidence based on a cumulative meta-analysis

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