Evidence map›Paper›PMID 21722362›Full record

SynthesisBMC medicine2011

The impact of diabetes on tuberculosis treatment outcomes: a systematic review.

Meghan A Baker, Anthony D Harries, Christie Y Jeon, Jessica E Hart, Anil Kapur, Knut Lönnroth, Salah-Eddine Ottmani, Sunali D Goonesekera, Megan B Murray

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02106039 (Concurrent Tuberculosis and Diabetes), which is not on this map. Cited by 469 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
469citing papers in PubMed, 16 pooled it
19.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02106039 nacompletednot on this mapstarted 2014, after this paper: background citation

Concurrent Tuberculosis and Diabetes: Clinical Monitoring, and Microbiological and Immunological Effects of Diabetes During Tuberculosis Treatment

TypeinterventionalSponsorUniversitas PadjadjaranRan2014 to 2017Enrolled350ConditionsDiabetes Mellitus, Pulmonary TuberculosisArmsintensive monitoring
3 · Its place in the literature

Who cites it

469 citing papers in PubMed, 16 syntheses or guidelines pooled it, 872 citations in OpenAlex.

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409 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 5 countries.

Meghan A BakerDepartment of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
Anthony D Harries
Christie Y Jeon
Jessica E Hart
Anil Kapur
Knut Lönnroth
Salah-Eddine Ottmani
Sunali D Goonesekera
Megan B Murray
Harvard University · USWorld Health Organization · CHBrigham and Women's Hospital · USBrown University · USInternational Union Against Tuberculosis and Lung Disease · FRMassachusetts General Hospital · USWorld Diabetes Foundation · DK

Funding

PROGRAM FOR AIDS CLINICAL RESEARCH TRAINING (PACRT)T32AI007433 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI MARK J SIEDNER · 1992 to 2026
$11.4M
6 · The paper itself

Abstract

backgroundMultiple studies of tuberculosis treatment have indicated that patients with diabetes mellitus may experience poor outcomes.We performed a systematic review and meta-analysis to quantitatively summarize evidence for the impact of diabetes on tuberculosis outcomes.

methodsWe searched PubMed, EMBASE and the World Health Organization Regional Indexes from 1 January 1980 to 31 December 2010 and references of relevant articles for reports of observational studies that included people with diabetes treated for tuberculosis. We reviewed the full text of 742 papers and included 33 studies of which 9 reported culture conversion at two to three months, 12 reported the combined outcome of failure and death, 23 reported death, 4 reported death adjusted for age and other potential confounding factors, 5 reported relapse, and 4 reported drug resistant recurrent tuberculosis.

resultsDiabetes is associated with an increased risk of failure and death during tuberculosis treatment. Patients with diabetes have a risk ratio (RR) for the combined outcome of failure and death of 1.69 (95% CI, 1.36 to 2.12). The RR of death during tuberculosis treatment among the 23 unadjusted studies is 1.89 (95% CI, 1.52 to 2.36), and this increased to an effect estimate of 4.95 (95% CI, 2.69 to 9.10) among the 4 studies that adjusted for age and other potential confounding factors. Diabetes is also associated with an increased risk of relapse (RR, 3.89; 95% CI, 2.43 to 6.23). We did not find evidence for an increased risk of tuberculosis recurrence with drug resistant strains among people with diabetes. The studies assessing sputum culture conversion after two to three months of tuberculosis therapy were heterogeneous with relative risks that ranged from 0.79 to 3.25.

conclusionsDiabetes increases the risk of failure and death combined, death, and relapse among patients with tuberculosis. This study highlights a need for increased attention to treatment of tuberculosis in people with diabetes, which may include testing for suspected diabetes, improved glucose control, and increased clinical and therapeutic monitoring.

Indexed as

Diabetes ComplicationsAntitubercular AgentsHumansSurvival AnalysisTreatment FailureTreatment OutcomeTuberculosisAntitubercular Agents

Identifiers

PMID21722362
PMCPMC3155828
OpenAlexW2117777873

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.