Most Read Articles
12 Jun 2019
Urogenital infections remain a major reason for women to visit their family physician and their subsequent referral to obstetrics and gynaecology or urology specialists. The association between abnormal vaginal microbiota and an increased risk of contracting sexually transmitted diseases (STDs), as well as an increased rate of preterm labour, indicates the need to better understand and manage urogenital health in women. Probiotics are “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host”. As such, there is a sound rationale for using probiotics to maintain female vaginal and bladder health.
Tristan Manalac, 6 days ago
Elderly coronavirus disease 2019 (COVID-19) patients with high nutritional risk appear to suffer worse outcomes, such as longer hospital stay and greater disease severity, according to a recent study.
01 Jan 2019
Twice-daily administration of a combined Lactobacillus rhamnosus and Lactobacillus helveticus probiotic in children with suspected gastroenteritis fails to prevent the development of moderate-to-severe gastroenteritis within 2 weeks after presentation, as shown in a recent study.
25 Oct 2018
Human papillomaviruses (HPVs) are commonly found in the oral cavity, but it does not appear that oral HPVs contribute to an increased risk of oesophageal cancer, according to a study.

HbA1c grading tied to drug resistance in TB patients with T2DM

04 Jun 2020

HbA1c grading influences the risk of developing isoniazid resistance and multidrug resistance (MDR) in tuberculosis (TB) infected patients with type 2 diabetes mellitus (T2DM), a study suggests.

Researchers reviewed relevant studies to pool existing evidence, conducted a multicentre retrospective clinical study to identify the impact of HbA1c on the development of anti-TB drug resistance, and developed a model to accurately predict and individually assess the development of MDR for TB–T2DM patients.

Results for the systematic review were inconsistent. Meanwhile, the multicentre chart review with 657 records consisted of 390 patients with HbA1c <7 percent and 267 with HbA1c ≥7 percent.

Patients in the HbA1c <7 percent group had a lower risk of developing rifampicin resistance (odds ratio [OR], 1.904; p=0.001), isoniazid resistance (OR, 2.896; p<0.001), and MDR (ORs, 3.228; p<0.001).

The model for MDR that included HbA1c grading demonstrated excellent predictive ability, with an area under the curve (AUC) of 75.4 percent in training set and 73.9 percent in internal validation set. The addition of HbA1c grading also significantly improved the model performance in calibration, prediction probabilities, and net clinical benefit.

There are several ways that HbA1c can induce anti-TB drug resistance. First is through the involvement of oxidative stress, which plays a crucial role in activation of resistance to isoniazid. Furthermore, hyperglycaemia may reduce the concentration of isoniazid in blood by delaying absorption and promoting elimination, with lower drug concentrations contributing to the development of drug resistance to a great degree. [Eur J Clin Pharmacol 2017;73:65-70; ACS Omega 2018;3:4213-4219; J Biol Chem 2018;293:17200-17207]

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Most Read Articles
12 Jun 2019
Urogenital infections remain a major reason for women to visit their family physician and their subsequent referral to obstetrics and gynaecology or urology specialists. The association between abnormal vaginal microbiota and an increased risk of contracting sexually transmitted diseases (STDs), as well as an increased rate of preterm labour, indicates the need to better understand and manage urogenital health in women. Probiotics are “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host”. As such, there is a sound rationale for using probiotics to maintain female vaginal and bladder health.
Tristan Manalac, 6 days ago
Elderly coronavirus disease 2019 (COVID-19) patients with high nutritional risk appear to suffer worse outcomes, such as longer hospital stay and greater disease severity, according to a recent study.
01 Jan 2019
Twice-daily administration of a combined Lactobacillus rhamnosus and Lactobacillus helveticus probiotic in children with suspected gastroenteritis fails to prevent the development of moderate-to-severe gastroenteritis within 2 weeks after presentation, as shown in a recent study.
25 Oct 2018
Human papillomaviruses (HPVs) are commonly found in the oral cavity, but it does not appear that oral HPVs contribute to an increased risk of oesophageal cancer, according to a study.