Glycaemic trends, trajectories and control during TB treatment and its association with TB treatment outcome among patients with TB–diabetes multimorbidity

Abstract

ABSTRACT Objectives: This study aimed to examine longitudinal glycaemic patterns, including trends, trajectories, and control during TB treatment, and their association with treatment outcomes in patients with Tuberculosis (TB) diabetes multimorbidity. Methodology: Analytical cross-sectional study was conducted, involving secondary analysis of an implementation study conducted at 13 Tuberculosis clinics in KPK and Punjab from June 2022 to June 2025. Random blood glucose (RBG) and glycated haemoglobin were measured at baseline, three months, and six months. Glycaemic trends, trajectories, and control status were reviewed, TB treatment outcomes were assessed at six months and associations were assessed using complete case and imputed datasets. Results: Among 251 participants, the mean age was 52.0±12.7 years and 60.6% (152/251) were males. Overall, 74.5% (187/251) achieved successful while 64 (25.5%) experienced unsuccessful TB treatment outcomes. TB treatment outcomes showed no significant association with RBG and HbA1c trends or trajectories in the complete case analysis (n=202) However, imputed dataset showed that the occurrence of unsuccessful outcome was higher as compared to successful outcome among those with uncontrolled RBG (96.9% vs 74.3%, p<0.001) and uncontrolled HbA1c (96.6% vs 67.9%, p<0.001), respectively. Binary logistic regression showed higher odds of experiencing unsuccessful outcome as compared to successful outcome due to uncontrolled RBG (OR=6.9; 95%CI: 1.8–27.7) and HbA1c (OR=9.0; 95%CI: 2.3–36.0). Conclusion: Longitudinal glycaemic patterns showed that most patients with TB–diabetes multimorbidity had uncontrolled glycaemia during treatment, which may affect TB outcomes. Larger studies are needed to better understand these relationships.