Management of DR-TB ADR: Dysglycaemia and Hyperglycemia

Dysglycaemia is a broad term that refers to an abnormality in blood sugar stability. This can include hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar).

Diagnosis of this Adverse Drug Reaction (ADR) is made through fasting blood glucose testing (>160 mg/dl is considered hyperglycaemia). The patient may present with increased thirst (polydipsia), excessive hunger (polyphagia) and excessive urination (polyuria).

Suspected agent(s): Ethionamide (Eto), Fluoroquinolone (FQ)

Suggested Management Strategies: Replace the offending drug with a suitable drug.

• If the patient is diabetic, they need to see a physician or get a diabetologist’s opinion.
• A minor form of this ADR presenting in a non-diabetic can be treated conservatively at the Peripheral Health Institute (PHI).
• If the case worsens, the patient is referred to Drug-resistant TB Centre (DR-TBC) for further investigations and treatment.

Points to Note

• Treat diabetes as needed.
• Good glucose control is important during treatment.

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
• Ready Reckoner for Medical Officer - Adverse Drug Reactions Associated with Anti-TB Drugs Identification and Management, 2019.​

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