The impact of diabetes mellitus on drug resistance in patients with newly diagnosed tuberculosis: a systematic review and meta-analysis.

BACKGROUND

Tuberculosis and diabetes mellitus are both important global health problems now. Previous studies have drawn different conclusions about the impact of diabetes on drug resistance in patients with newly diagnosed tuberculosis.

METHODS

We conducted a systematic search in four databases: PubMed, EMBSE, Cochrane Library, and Web of Science. The relative risk (RR) was applied to assess the association of diabetes with drug resistance and the STATA version 12.0 was used for data synthesis.

RESULTS

A total of 13 studies involving 33,747 patients were included in our study. The pooled results revealed that presence of diabetes was significantly associated with isoniazid resistance (RR =1.22, 95% CI: 1.04-1.43) in patients with newly diagnosed tuberculosis. However, no significant impact of diabetes on rifampicin resistance (RR =0.67, 95% CI: 0.41-1.11) or multi-drug resistance (MDR) (RR =1.28, 95% CI: 0.93-1.75) was observed. The results of subgroup analysis were similar to the pooled results. No significant publication bias for the results of MDR was found.

CONCLUSIONS

In patients with newly diagnosed tuberculosis, diabetes is associated with isoniazid resistance. However, there is no significant impact of diabetes on the rifampicin resistance or MDR. However, these findings still need to be verified in the future.