Glycemic Control: A Strategic Approach for Successful Tuberculosis Treatment in Patients with Comorbid Diabetes Mellitus
https://doi.org/10.58838/2075-1230-2026-104-3-48-55
Abstract
The objective: to identify factors contributing to dysglycemia in patients with pulmonary tuberculosis and comorbid diabetes mellitus, and to assess the effectiveness of dysglycemia management based on the 24-hour glycemic variability.
Materials and methods. The study included 51 HIV-negative patients with advanced tuberculosis (TB) and decompensated type 1 or type 2 diabetes.
Results. Infection-induced dysglycemia driven by active TB was found to be the leading cause of glycemic decompensation in 98.0% of patients; this condition was frequently compounded by dietary non-compliance, poor self-monitoring, and drug-drug interactions. The introduction of the 24-hour glycemic variability as an additional clinical parameter enabled careful monitoring of glucose-lowering therapy resulting in glycemic profile stabilization within 3–8 weeks. Against this background, combined with the optimization of TB therapy, this approach yielded favorable TB treatment outcomes demonstrated by the radiographic improvements in 66.7% of patients, with the median time to sputum conversion of 2.2 months. Joint management by phthisiologists and endocrinologists combined with management of dysglycemia represents a strategic approach to enhancing TB treatment efficacy in this patient population.
About the Authors
V. V. Tinkova
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Ministry of Health of the Russian Federation; N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Valentina V. Tinkova, Candidate of Medical Sciences, Deputy Chief Physician for Medical Affairs, Assistant Professor, Department of Phthisiology
127473, Moscow, 4 Dostoevsky Street, Building 2;
Tel.: +7 (495) 631-15-15
O. V. Lovacheva
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Olga V. Lovacheva, Doctor of Medical Sciences, Professor, Chief Researcher, Department of Differential Diagnosis and Treatment of Tuberculosis and Co-infections
127473, Moscow, 4 Dostoevsky Street, Building 2;
Tel.: +7 (495) 631-15-15
D. O. Churkin
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Denis O. Churkin, TB specialist, Department of Respiratory Tuberculosis
127473, Moscow, 4 Dostoevsky Street, Building 2;
Tel.: +7 (495) 631-15-15
A. K. Karaeva
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Alina K. Karaeva, Endocrinologist
127473, Moscow, 4 Dostoevsky Street, Building 2;
Tel.: +7 (495) 631-15-15
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Review
For citations:
Tinkova V.V., Lovacheva O.V., Churkin D.O., Karaeva A.K. Glycemic Control: A Strategic Approach for Successful Tuberculosis Treatment in Patients with Comorbid Diabetes Mellitus. Tuberculosis and Lung Diseases. 2026;104(3):48-55. (In Russ.) https://doi.org/10.58838/2075-1230-2026-104-3-48-55
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