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Background <p>Type 2 Diabetes Mellitus (T2DM) and Pulmonary Tuberculosis (PTB) frequently coexist in developing countries, leading to worsened clinical outcomes due to immune suppression and metabolic disturbances. T2DM impairs infection control, while PTB affects glycemic regulation. Therefore, selecting an appropriate antidiabetic agent is crucial in managing both conditions. Metformin has insulin-sensitizing properties and potential host-directed anti-TB effects. In contrast, Glimepiride increases insulin secretion but lacks immunomodulatory action.</p> Objective <p>To compare the effects of metformin and glimepiride on glycemic control, immune response, and tuberculosis (TB) treatment outcomes in people with Type 2 Diabetes Mellitus (T2DM) co-diagnosed with TB.</p> Methods <p>A prospective cohort study was conducted from November 2024 to May 2025 at the NTEP Centre, Government General Hospital, Ananthapuramu. A total of 138 people with T2DM and PTB were enrolled, of whom 76 received Metformin and 62 received Glimepiride.</p> Results <p>Metformin significantly reduced random blood sugar (RBS) from 248.05 to 181.32&#xa0;mg/dL, while Glimepiride showed an increase from 253.35 to 273.74&#xa0;mg/dL (<i>p</i> &lt; 0.0001). As the intensive phase is crucial for early treatment response, sputum conversion at 2&#xa0;months was assessed, with the Metformin group showing a conversion rate of 34% compared to 9.6% in the Glimepiride group. By four months, sputum conversion remained higher in the Metformin group (85%) compared to the Glimepiride group (37%). Metformin also reduced WBC count (7573.68 vs. 17,930.65) and ESR (16.65 vs. 30.85) levels by six months. Participants receiving metformin experienced a reduction in body weight, whereas those receiving glimepiride experienced weight gain.</p> Conclusion <p>Metformin was associated with superior outcomes in glycemic control, TB sputum conversion, inflammation reduction, and weight management. It may be a more suitable antidiabetic agent for people with T2DM and PTB. Further research is warranted to assess long-term effects.</p>

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Comparative analysis of metformin and glimepiride in people diagnosed with type 2 diabetes mellitus and tuberculosis

  • 期刊论文

  • 发表日期：

    2026年7月2日

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  • Yuvallika Kandlapalli,
  • Vyshnavi Amberkar Venkata,
  • Rajavardhana Thamineni,
  • Venkata Mohan Krishna Chakali,
  • Rajanandh MG,
  • Sruthi Marthadu

摘要

Background

Type 2 Diabetes Mellitus (T2DM) and Pulmonary Tuberculosis (PTB) frequently coexist in developing countries, leading to worsened clinical outcomes due to immune suppression and metabolic disturbances. T2DM impairs infection control, while PTB affects glycemic regulation. Therefore, selecting an appropriate antidiabetic agent is crucial in managing both conditions. Metformin has insulin-sensitizing properties and potential host-directed anti-TB effects. In contrast, Glimepiride increases insulin secretion but lacks immunomodulatory action.

Objective

To compare the effects of metformin and glimepiride on glycemic control, immune response, and tuberculosis (TB) treatment outcomes in people with Type 2 Diabetes Mellitus (T2DM) co-diagnosed with TB.

Methods

A prospective cohort study was conducted from November 2024 to May 2025 at the NTEP Centre, Government General Hospital, Ananthapuramu. A total of 138 people with T2DM and PTB were enrolled, of whom 76 received Metformin and 62 received Glimepiride.

Results

Metformin significantly reduced random blood sugar (RBS) from 248.05 to 181.32 mg/dL, while Glimepiride showed an increase from 253.35 to 273.74 mg/dL (p < 0.0001). As the intensive phase is crucial for early treatment response, sputum conversion at 2 months was assessed, with the Metformin group showing a conversion rate of 34% compared to 9.6% in the Glimepiride group. By four months, sputum conversion remained higher in the Metformin group (85%) compared to the Glimepiride group (37%). Metformin also reduced WBC count (7573.68 vs. 17,930.65) and ESR (16.65 vs. 30.85) levels by six months. Participants receiving metformin experienced a reduction in body weight, whereas those receiving glimepiride experienced weight gain.

Conclusion

Metformin was associated with superior outcomes in glycemic control, TB sputum conversion, inflammation reduction, and weight management. It may be a more suitable antidiabetic agent for people with T2DM and PTB. Further research is warranted to assess long-term effects.