Feasibility assessment of facility based blood glucose monitoring among patients with Tuberculosis in North India

Abstract

Background: Screening TB patients for Diabetes Mellitus (DM) could be an efficient tool for early diagnosis of DM leading to improved treatment outcomes and integrated management of TB-DM co-morbidity. It is feasible to conduct bidirectional screening for diabetes and TB in India, but the most effective way of doing it is still unknown. Objective: To assess the technical feasibility for glucometer based blood glucose assessment among TB patients and change of blood glucose during their treatment course at secondary health care centers of Northern Indian state. Methods: Prospective study was conducted among all patients diagnosed with TB at the three selected health facilities (District Hospital (DH), Community Health Centres (CHC)-1 and 2). All diagnosed TB patients were assessed for random blood glucose (RBG) using glucometer at three times during anti TB treatment. Results: A total of 200 TB patients were recruited andRBG across facilities observed a statistically significant decline ranging from 35.9 mg/dl in CHC-1 to 36.0 mg/dl in DH. On applying repeated measures model estimated average RBG means at the three points of contact in the TB patients were almost similar to original means and the reduction from baseline to second follow up was statistically significant also for type of facility (mean reduction for CHC Shahpur: 31.17; CHC NB: 30.98; DH Kangra: 27.00 mg/dl; p=0.00). The reduction from baseline to second follow up was still statistically significant when stratified for type of facility and diabetes status. (p=0.01) Conclusion: RBG or fasting blood glucose testing is feasible at health facility (primary or secondary level) during the registration of patient and during and after treatment completion.