Estimation of glycemic control in patients with type 2 diabetes mellites with various forms of tuberculosis with dots

Abstract

Since ancient times people are aware of the association between tuberculosis and diabetes mellitus. Patients with tuberculosis and diabetes experience worse clinical manifestations, increased risk of treatment failure, recurrence, and death. The present study was conducted to evaluate glycosylated hemoglobin (HbA1c) and blood glucose levels, in patients with Type - 2 diabetes mellitus with various forms of tuberculosis who are on RNTCP DOTS and antidiabetic regimens. The study subjects included Type-2 diabetes mellitus with tuberculosis who are registered under RNTCP DOTS, in Dept of Pulmonology, PESIMSR, Kuppam, Chittoor district. Study groups comprises, 20 cases of type 2 DM WITH TB who are on oral hypo glycemic agents (OHA), 20 cases of Type 2DM WITH TB who are on oral hypoglycemic agents (OHA) with insulin, 20 cases of Type 2 DM WITH TB who are on insulin. HbAc is measured by fully automatic Bio-Rad D10 - HbA1c Analyzer. Blood glucose levels are estimated by auto analyser VITROS 250 in PESIMSR, Kuppam. The mean HbA1c levels showed good control in those patients kept on insulin alone compared to OHA and OHA with insulin groups (P <0.001). The mean HbAC levels were high in OHA alone group compared to other groups (P<0.001). The study revealed that increased levels of Glycosylated haemoglobin (HbA1C) are observed in those patients kept on OHA alone with DOTS as compared with other two groups. There is strong interaction between anti tubercular drugs and OHA which in turn leads to poor glycemic control. Poor glycemic state in diabetic patients is having strong impact on TB treatment outcome.