Prevalence and risk factors of pre-diabetes and diabetes among patients with active TB disease attending three RNTCP centres in Odisha

Abstract

Type 2 diabetes mellitus (T2DM) and tuberculosis (TB) often present together and complicate each other at many levels. The Revised National Tuberculosis Control Program (RNTCP) calls for strengthening collaboration between TB and diabetes control programs for better management of diabetic patients with TB. In this study, we determined the prevalence of pre-diabetes and diabetes among 220 TB patients registered in selected tuberculosis units (TUs) of RNTCP in hospitals of three different regions of Odisha namely Bhubaneswar, Cuttack and Nayagarh. Various socio-demographic factors like age, gender, marital status, literacy status, locality, habits, etc. and clinical profile were assessed. Out of 220 TB patients, 24 % patients were having pre-diabetes and 14 % patients were having diabetes. Both the conditions, pre-diabetes or diabetes, were more common among males, married patients, advancing age, having less education, no specific job, sedentary lifestyle, smoking/drinking, living in crowded areas, poor living conditions and unhygienic environment. Majority of pre-diabetic and diabetic patients were having pulmonary TB with 1+ sputum positivity and category (Cat)-I type of treatment. The variations in random blood glucose (RBG) and fasting blood glucose (FBG) levels among people with pre-diabetes are very less whereas those among people with diabetes were very high, thereby indicating that the blood glucose levels show more fluctuations before and after intake of food. Further, our results show that 57 % were not knowing that they were pre-diabetic and 43 % were not aware that they were having diabetes. It is feasible to screen TB patients for diabetes resulting in high rates of T2DM detection. Screening for diabetes mellitus (DM) in TB patients could improve DM case detection and early treatment, indirectly leading to better TB-specific treatment outcomes and prevention of DM complications.