Dual Model with Nursing for DM-TB Comorbidity: A Clinical Study

Objectives

To evaluate the efficacy of a dual diagnostic and therapeutic model combined with targeted nursing interventions in patients with concurrent diabetes mellitus (DM) and tuberculosis (TB), and to assess its impact on clinical outcomes and quality of life.

Methods

A prospective randomized controlled trial was conducted involving 286 patients with DM-TB comorbidity from January 2022 to December 2024. Participants were randomly assigned to either the integrated care group (n = 143), receiving the dual diagnostic and therapeutic model with specialized nursing interventions, or the conventional care group (n = 143), receiving standard treatment protocols. The dual model incorporated coordinated endocrinology-pulmonology consultations, personalized glycemic management, and anti-tuberculosis therapy optimization. Primary outcomes included TB treatment success rates, glycemic control (HbA1c levels), and adverse events. Secondary outcomes encompassed treatment adherence, hospital readmission rates, and quality of life scores.

Results

The integrated care group demonstrated significantly higher TB treatment success rates (91.6% vs. 78.5%, P < 0.001) and superior glycemic control (mean HbA1c reduction: 2.3% vs. 1.4%, P < 0.001) compared to conventional care. Medication adherence improved substantially (88.8% vs. 71.3%, P < 0.001), while adverse events decreased (15.4% vs. 28.7%, P = 0.006). Hospital readmission rates were lower (12.6% vs. 24.5%, P = 0.011), and quality of life scores improved significantly (P < 0.001).

Conclusions

The dual diagnostic and therapeutic model with integrated nursing interventions substantially enhances treatment outcomes in DM-TB comorbidity, offering a promising framework for clinical practice.

Key messages

• Diagnostic-therapeutic model with targeted nursing significantly improves TB treatment success (91.6% vs. 78.5%) and glycemic control in DM-TB comorbid patients.

• The integrated care for DM-TB comorbidity boosts medication adherence, reduces adverse events and readmissions, and improves quality of life.