EVALUATION OF AN INTERMITTENT SIX-MONTH REGIMEN IN NEW PULMONARY TUBERCULOSIS PATIENTS WITH DIABETES MELLITUS

Summary Background: The treatment of tuberculosis (TB) with category I regimen of the Revised National Tuberculosis Control Programme (RNTCP) for patients with diabetes mellitus (DM) needs evaluation. Objective: To assess the cure and relapse rates in 3 years, among the new smear-positive TB patients with Type-2 DM (DMTB) treated with CAT-I regimen (2E 3 H 3 R 3 Z 3 /4R 3 H 3 ) of RNTCP. Methodology: TB suspects attending the diabetology units and the TB research centre (TRC) Chennai, were investigated. Eligible DMTB cases were enrolled. Baseline estimation of cardiac, renal, liver function tests and glycosylated-HBA1c were undertaken. All patients received 2E 3 H 3 R 3 Z 3 /4R 3 H 3 under supervision at TRC. Clinical and sputum (smear and culture) examinations and monitoring of diabetic status were undertaken every month up to 24 months, then once in 3 months up to 36 months. Results: Of 100 patients admitted, 7 were excluded for various reasons from analysis. Of 93 patients, 87 (94%) had a favourable response at the end of treatment. Pre and post treatment mean glycosylated-HBA1c were 9.7% and 8.4 %.(>7% poor control). During follow-up period, 6 died and one lost to follow-up. Of the remaining, four relapsed. Conclusion: Category-I regimen, recommended for all the new smear-positive patients in the Indian TB programme, is effective in the treatment of DMTB patients, despite poor control of diabetes.