“PREVALENCE OF TB IN PATIENTS WITH DM UNDER REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME”

Abstract

Background: DM has been shown to be an independent risk factor for TB, and there is evidence showing high DM prevalence in TB patients in studies mainly from the southern part of India. This strong association between DM and TB raises the question as to whether TB patients should be routinely screened for DM. Many studies have been conducted to establish the relation between TB and DM using fasting blood glucose as the parameter.
 Objective: The primary objective of this study was to detect the prevalence of Diabetes Mellitus in the newly diagnosed TB patients by HbA1C and Fasting Blood Glucose.
 Design: This was a Cross Sectional study.
 Duration: The present study was conducted from January 2015 to June 2016.
 Setting: Shadan Institute of Medical Sciences, Hyderabad.
 Participants: 280 patients diagnosed with tuberculosis at the chest clinic of Shadan Institute Of Medical Sciences, Hyderabad.
 Methods: 140 out of the 280 patients who were diagnosed as TB underwent blood tests for Fasting Blood Glucose and HbA1C along with the routine investigations like CBP, ESR, Chest X ray, ECG, Sputum examination. The data of patients with TB and DM and patients with only TB was compared. The data of pulmonary and extra pulmonary TB groups was compared. The data of sputum positive and sputum negative groups was compared. Student’s t test was performed for normally distributed continuous variables and a p value was derived.
 Results: 38(27%) out of 140 patients had abnormal HbA1c i.e. > 6.5% having a strong association with male gender and age more than 45 years. The majority of the patients who had diabetes in this study, also had sputum positive TB(57%). This study showed a significant difference in mean age between the two groups of TB with diabetes(44.88 ± 5.721) and TB without DM(34.598 ± 10.56).
 Conclusion: There was a high prevalence of DM amongst the TB patients registered under RNTCP. Diabetes makes a substantial contribution to the burden of incident tuberculosis in India, and the association is particularly strong for the infectious form of tuberculosis. The current diabetes epidemic may lead to a resurgence of tuberculosis in endemic regions, especially in urban areas. This potentially carries a risk of global spread with serious implications for tuberculosis control.
 Keywords: Tuberculosis, Diabetes Mellitus, Blood Glucose, Sputum.