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INTRODUCTION:India is considered as the diabetic capital of the world. Diabetic foot osteomyelitis is considered as one of the severe complications of diabetes mellitus. Diabetic foot osteomyelitis tends to complicate around one third of diabetic foot infections. In view of this we conducted a prospective study on the bacteriological analysis of diabetic foot osteomyelitis at a tertiary care center. MATERIALS AND METHODS: A prospective study was performed at a tertiary care hospital in India. 78 Diabetic patients with foot ulcers were recruited in the study during the year June 2013 to November 2014 after obtaining written informed consent. All subjects underwent detailed clinical examination. Foot x-ray was done and cases which showed evidence of osteomyelitis were chosen for the study. Swab/tissue samples after debriding the wound were collected aseptically from the wound site and sent for blood culture, isolation and identification of bacteria. Antibiotic sensitivity tests for the isolated bacteria were performed by disc diffusion method against commonly used antibiotics. RESULTS: In our study we found that most diabetic foot infections with osteomyelitis occur after 10 years of the onset of diabetes mellitus, most belonged to age group 41 to 50yrs. Altogether 86 bacteria were isolated from 54 cases. Among 82 bacterial isolates, 54 (63 %) were Gram negative. CONCLUSION: Diabetic foot osteomyelitis are caused majority by gram negative bacteria, followed by gram positive organism.

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Since ancient times people are aware of the association between tuberculosis and diabetes mellitus. Patients with tuberculosis and diabetes experience worse clinical manifestations, increased risk of treatment failure, recurrence, and death. The present study was conducted to evaluate glycosylated hemoglobin (HbA1c) and blood glucose levels, in patients with Type - 2 diabetes mellitus with various forms of tuberculosis who are on RNTCP DOTS and antidiabetic regimens. The study subjects included Type-2 diabetes mellitus with tuberculosis who are registered under RNTCP DOTS, in Dept of Pulmonology, PESIMSR, Kuppam, Chittoor district. Study groups comprises, 20 cases of type 2 DM WITH TB who are on oral hypo glycemic agents (OHA), 20 cases of Type 2DM WITH TB who are on oral hypoglycemic agents (OHA) with insulin, 20 cases of Type 2 DM WITH TB who are on insulin. HbAc is measured by fully automatic Bio-Rad D10 - HbA1c Analyzer. Blood glucose levels are estimated by auto analyser VITROS 250 in PESIMSR, Kuppam. The mean HbA1c levels showed good control in those patients kept on insulin alone compared to OHA and OHA with insulin groups (P <0.001). The mean HbAC levels were high in OHA alone group compared to other groups (P<0.001). The study revealed that increased levels of Glycosylated haemoglobin (HbA1C) are observed in those patients kept on OHA alone with DOTS as compared with other two groups. There is strong interaction between anti tubercular drugs and OHA which in turn leads to poor glycemic control. Poor glycemic state in diabetic patients is having strong impact on TB treatment outcome.

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