Diabetes mellitus and risk of all-cause mortality among patients with tuberculosis in the state of Georgia, 2009-2012

Ann Epidemiol. 2014 May;24(5):369-75. doi: 10.1016/j.annepidem.2014.01.012. Epub 2014 Feb 8.


Purpose: To estimate the association between diabetes mellitus (DM) and all-cause mortality during tuberculosis (TB) treatment.

Methods: From 2009 to 2012, a retrospective cohort study among reported TB cases in Georgia was conducted. Patients aged 16 years or older were classified by DM and human immunodeficiency virus (HIV) status at the time of TB diagnosis and followed during TB treatment to assess mortality. Hazard ratios were used to estimate the association between DM and death.

Results: Among 1325 patients with TB disease, 151 (11.4%) had DM, 147 (11.1%) were HIV-infected, and seven (0.5%) had both DM and HIV. Patients with TB-DM were more likely to have cavitary lung disease compared with those with TB alone (51.0% vs. 34.7%) and those with TB-HIV were more likely to have military/disseminated disease (12.9% vs. 3.4%) and resistance to rifampin or isoniazid (21.8% vs. 9.0%) compared with those without HIV infection (P < .05). In multivariable analysis, DM was not associated with death during TB treatment (hazard ratio, 1.22; 95% confidence interval, 0.70-2.12) or any death (adjusted odds ratio, 1.05; 95% confidence interval, 0.60-1.84).

Conclusions: Among TB patients in Georgia, the prevalence of comorbid DM and coinfection with HIV was nearly identical. In adjusted models, TB patients with DM did not have increased risk of all-cause mortality.

Keywords: Diabetes mellitus; Georgia; HIV; Mortality; Tuberculosis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use
  • Cause of Death
  • Coinfection / drug therapy
  • Coinfection / epidemiology
  • Coinfection / mortality
  • Comorbidity
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Follow-Up Studies
  • Georgia / epidemiology
  • HIV Infections / epidemiology
  • HIV Infections / mortality
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Self Report
  • Tuberculosis / drug therapy
  • Tuberculosis / epidemiology
  • Tuberculosis / mortality*
  • Young Adult


  • Antitubercular Agents