Challenges of Diabetes Management among TBDiabetes co-morbid Patients in Udupi District

Abstract

Introduction: India has witnessed a rise in TB-Diabetes co-morbid cases in the past few years. Both TB and diabetes create complications for each other not only in terms of the prognosis but also management. Glycaemic control is pivotal for the successful management of diabetes and the co-morbidity. Aim: To understand the barriers and challenges of successful management of diabetes among TB-Diabetes co-morbid patients in the Udupi district. Methods: This cross-sectional study was conducted in the Udupi district of Karnataka from January 2020 to June 2020. Purposively selected Healthcare providers under RNTCP, were interviewed using a semi-structured interview guide. Each interview was fully transcribed. Data collection was terminated on reaching data saturation. A manual thematic analysis of the interview data was done using an inductive approach. Codes and themes were generated by a critical review of the transcripts. Results: Healthcare providers stated that certain patients such as, elderly, the homeless, and those with habits like alcoholism, were particularly difficult to manage. Besides, poor socioeconomic status, misconceptions, and lack of treatment adherence often create difficulties. Finally, participants also stressed the shortage of staff which impedes efficient management of the comorbidity. Conclusion: This study identified several barriers and challenges of diabetes management among TB-Diabetes co-morbid patients. These impediments, such as alcoholism, misconceptions, staff shortage, if addressed could aid in the better management of diabetes and eventually the co-morbidity.