Role of Diabetes Mellitus on Adverse Drug Reaction to Anti-tuberculosis Drugs

Abstract

Introduction: Tuberculosis (TB) is one of the leading cause of death among infectious diseases. The dual burden of TB and diabetes mellitus (DM) is a major economic and health concern. Anti-TB therapy may predispose patients to develop adverse drug reaction (ADR). The effect of DM on anti-TB ADR requires more studies. Methods: We performed a cross-sectional study and followed patients for at least two  years. Patients were selected from three Malaysian teaching hospitals. TB patients, and diabetic patients with TB were divided into two groups of 200 subjects each. Data were obtained from patients’ medical files at the beginning and end of the study  period. Prevalence of serious adverse drug reaction (ADR) requiring dose adjustment was assessed. Results: ADR in our subjects was documented in the medical records and confirmed by a system known as Challenge. The prevalence rates of ADR amongst DM-TB and TB only patients were 16.5% and 14.8%, respectively, but the difference was not significant (Fisher E.T: P > 0.05). ADR was more frequent with streptomycin treatment, partially because of its painful administration. Isoniazid treatment showed the least frequency of ADR. Conclusion: Although the frequency of ADR was high among DM-TB patients, it was not significantly different to that among TB only patients.