Novel treatment (new drug/intervention; established drug/procedure in new situation)
The impact of tuberculosis treatment on glycaemic control and the significant response to rosiglitazone
Medical Coordinator of the Diabetes Education and Control Groups at the Kidney and Hypertension Hospital, Federal University of São Paulo, and at the Diabetes Center, Oswaldo Cruz German Hospital, Sao Paulo, Brazil
Correspondence to:
Augusto Pimazoni, pimazoni{at}uol.com.br
This case involves a 43-year-old female patient with highly uncontrolled type 2 diabetes for the past 14 years. Her weekly mean (SD) glycaemia (WMG) concentration at week 1 was 20.9 (4.8) mmol/l (377 (87) mg/dl). Four weeks after reaching full control at week 3 with insulin glargine plus regular insulin and metformin (WMG 7.0 (1.9) mmol/l (127 (34) mg/dl)) she was diagnosed with acute pulmonary tuberculosis and treated with rifampicin, isoniazid and pyrazinamide, which caused her to lose glycaemic control (WMG 21.0 (7.1) mmol/l (378 (128) mg/dl)). No other potentially hyperglycaemic drug such as corticosteroid was used. During this entire period she was intensively treated with NPH (neutral protamine Hagedorn) and regular insulins, reaching a total daily dose of 170 IU, but with no clinical response. Together with insulin therapy, rosiglitazone was started at week 12 and glycaemic control returned to normal within just 3 weeks (WMG 6.6 (2.9) mmol/l (120 (53) mg/dl)).
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