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BackgroundDiabetes mellitus (DM) is recognised as an important risk factor to tuberculosis (TB). India has high TB burden, along with rising DM prevalence. There are inadequate data on prevalence of DM and pre-diabetes among TB cases in India. Aim was to determine diabetes prevalence among a cohort of TB cases registered under Revised National Tuberculosis Control Program in selected TB units in Tamil Nadu, India, and assess pattern of diabetes management amongst known cases.Methods827 among the eligible patients (n = 904) underwent HbA1c and anthropometric measurements. OGTT was done for patients without previous history of DM and diagnosis was based on WHO criteria. Details of current treatment regimen of TB and DM and DM complications, if any, were recorded. A pretested questionnaire was used to collect information on sociodemographics, habitual risk factors, and type of TB.FindingsDM prevalence was 25.3% (95% CI 22.6–28.5) and that of pre-diabetes 24.5% (95% CI 20.4–27.6). Risk factors associated with DM among TB patients were age (31–35, 36–40, 41–45, 46–50, >50 years vs <30 years) [OR (95% CI) 6.75 (2.36–19.3); 10.46 (3.95–27.7); 18.63 (6.58–52.7); 11.05 (4.31–28.4); 24.7 (9.73–62.7) (p<0.001)], positive family history of DM [3.08 (1.73–5.5) (p<0.001)], sedentary occupation [1.69 (1.10–2.59) (p = 0.016)], and BMI (18.5–22.9, 23–24.9 and ≥25 kg/m2 vs <18.5 kg/m2) [2.03 (1.32–3.12) (p = 0.001); 0.87 (0.31–2.43) (p = 0.78); 1.44 (0.54–3.8) (p = 0.47)]; for pre-diabetes, risk factors were age (36–40, 41–45, 46–50, >50 years vs <30 years) [2.24 (1.1–4.55) (p = 0.026); 6.96 (3.3–14.7); 3.44 (1.83–6.48); 4.3 (2.25–8.2) (p<0.001)], waist circumference [<90 vs. ≥90 cm (men), <80 vs. ≥80 cm (women)] [3.05 (1.35–6.9) (p = 0.007)], smoking [1.92 (1.12–3.28) (p = 0.017)] and monthly income (5000–10,000 INR vs <5000 INR) [0.59 (0.37–0.94) (p = 0.026)]. DM risk was higher among pulmonary TB [3.06 (1.69–5.52) (p<0.001)], especially sputum positive, than non-pulmonary TB.InterpretationNearly 50% of TB patients had either diabetes or pre-diabetes.

OBJECTIVE -Due to a background of high prevalence of type 2 diabetes and the increasing rate of obesity occurring in relatively young urban children, we felt the need to look for type 2 diabetes in children. RESEARCH DESIGN AND METHODS-A study of cases of type 2 diabetes with age at diagnosis of Յ15 years seen at a diabetes speciality center in Chennai, India, is reported. A total of 18 children (5 boys and 13 girls) aged 9 -15 years with insidious onset of diabetes responding to oral antidiabetic agents (ODAs) for periods from 2 months to 12 years were studied. Clinical details, anthropometry, and details of family history of diabetes were elicited. All of them were tested for the presence of anti-GAD 65 antibodies and for pancreatic ␤-cell reserve by measuring serum C-peptide response (radioimmunoassay procedures).RESULTS -All children showed a response to ODAs, had good ␤-cell reserve (Ն0.6 pmol/ml on stimulation), and negligible GAD 65 antibodies indicating the presence of type 2 diabetes. The children were nonketotic; nine were obese, four had acanthosis nigricans, and one had polycystic ovary syndrome. Positive family history of diabetes was present in all cases.CONCLUSIONS -The clinical, immunological, and biochemical profile showed that the children had type 2 diabetes. The profile of type 2 diabetes was similar to that described in children in many other countries. Although less common than type 1 diabetes, type 2 diabetes in children is a condition that needs to be recognized and looked for in Asian-Indians. Diabetes Care 26:1022-1025, 2003T ype 2 diabetes poses a major health problem globally, especially in many developing countries (1). In urban India, type 2 diabetes is reaching epidemic proportions (2-5). Diabetes develops at a younger age in Indians, i.e., at least a decade or two earlier than in the Western population (4,6). We have reported a high prevalence of maturityonset diabetes of the young (MODY) in our population (7). Reports from different parts of the world, especially from the U.K. (8 -10) and the U.S. (11-13), show an increasing occurrence of type 2 diabetes in children, particularly in the minority populations, including Asians. The American Diabetes Association has highlighted a high prevalence of type 2 diabetes in children in ethnic minority populations such as the American and Canadian Indians, Hispanics, African Americans, Japanese, Pacific Islanders, and Asian and Middle-Eastern populations (14). Obesity has been on the rise in the adolescent age, which might have a causative role for the rising prevalence of diabetes in the young (8 -13,15).A recent survey in southern India has shown that obesity among adolescent school children was related to decreased physical activity (16). It is likely that with the emerging epidemic of diabetes and obesity, type 2 diabetes could occur in children in India. This report highlights the need to look for type 2 diabetes in children in India.RESEARCH DESIGN AND METHODS -Children with diabetes diagnosed Յ15 years who had features of type 2 diab...

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Clustering of the cardiovascular risk factors or the components of insulin resistance syndrome occurs in the native Asian Indian population. This finding under-scores the need for preventive aspects of metabolic disorders and CHD.