Rationale: Patients with newly diagnosed
tuberculosis often have inconsistent glycemic measurements during and
after treatment. Distinct glycemic trajectories after the diagnosis of
tuberculosis are not well characterized, and whether patients with stress
hyperglycemia have poor treatment outcomes is not known.Objectives: To identify distinct glycemic trajectories from the point of
tuberculosis diagnosis to the posttreatment period and to assess the relationship between glycemic trajectories and
tuberculosis treatment outcomes.Methods: Patients with newly diagnosed, drug-susceptible
tuberculosis and with at least three fasting plasma
glucose tests at
tuberculosis diagnosis and during the third and sixth month of treatment were identified and included from Jiangsu Province, China. Patients were also given an additional fasting plasma
glucose test at 2 and 4 months
after treatment.Measurements and Main Results: Several distinct glycemic trajectories from the point of
tuberculosis diagnosis to the posttreatment period were found, including consistently normal glycemic testing results (43%), transient
hyperglycemia (24%), erratic glycemic instability (12%), diabetes (16%), and consistent
hyperglycemia without diabetes (6%). Compared with participants with a consistently normal glycemic trajectory, patients with transient
hyperglycemia were more likely to experience treatment failure (adjusted odds ratio [AOR], 4.20; 95% confidence interval [CI], 1.57-11.25; P = 0.004) or erratic glycemic instability (AOR, 5.98; 95% CI, 2.00-17.87; P = 0.001). Patients living with diabetes also had a higher risk of experiencing treatment failure (AOR, 6.56; 95% CI, 2.22-19.35; P = 0.001), and this was modified by
glycemic control and
metformin use.Conclusions: Among patients with
tuberculosis without diabetes, glycemic changes were common and may represent an important marker for patient response to
tuberculosis treatment.