TUBERCULOSIS AND DIABETES MELLITUS- NOT A SWEET ASSOCIATION!

Abstract

BACKGROUND Tuberculosis (TB) continues to be the leading killer among bacterial diseases worldwide. Diabetes is making people three times more susceptible to get active tuberculosis infection. Diabetes Mellitus (DM) is quietly fuelling the spread of tuberculosis. The association between diabetes and TB may be the next challenge for global tuberculosis control worldwide. This study aims to find out proportion of DM among pulmonary tuberculosis patients and proportion of DM among patients with different sputum bacillary load. MATERIALS AND METHODS An observational cross-sectional study was conducted at MLN Medical College, Allahabad. A total of 1691 presumptive TB cases aged >= 18 years were enrolled, out of them 257 sputum smear positive pulmonary TB cases were included in the study. Data were collected using a structured questionnaire to elicit demographic and clinical variables including a history of diabetes. An HbA1c value of 6.5% or above was considered diagnostic of DM. Data was analysed on Microsoft Office Excel worksheet. RESULTS Out of total 1691 presumptive TB cases enrolled, 257 were diagnosed as sputum smear positive pulmonary TB cases. Both TB and DM were more common among males. Proportion of DM among sputum positive pulmonary TB patients was 7.39%. Proportion of DM is 8.33% among patients with bacillary load 3+ and 7.04% among patients with bacillary load 1+. Proportion of DM increases in pulmonary TB patients with older age. DM proportion was 3.7% among patients age <40 years, while proportion was 14.2% among patients age >60 years (p-value=0.012). CONCLUSION In conclusion, this study shows a high proportion of DM among males, patients with active TB, older age group and in patients with high sputum bacillary load. An improved understanding of the bidirectional relationship of the two diseases is necessary for proper planning and collaboration to reduce the dual burden of diabetes and TB. We should increase public awareness about the risk factors or association of TB and DM together.