Diabetes Mellitus and Prediabetes among Patients with Tuberculosis in a Single North Indian Tertiary Care Centre

Abstract

Background Prevalence of diabetes mellitus (DM), though believed to be high among patients with tuberculosis (TB), remains unclear for the want of systematic studies and unequivocal methods of diagnosing DM. This study was done to determine the prevalence of prediabetes and DM in adult patients with TB. Methods This prospective study of one year's duration, carried out at a tertiary care centre included 313 consecutive adult patients diagnosed (either microbiologically, histologically or based on clinical presentation) with pulmonary or extrapulmonary TB. Those without a history of pre-existing DM were subjected to oral glucose tolerance test (OGTT) with 75 g glucose. Results In this cohort 85 (27%) patients had pre-existing DM. The remaining 228 patients not diagnosed earlier with DM underwent a 75 g OGTT, of which 63 (28%) were found to have newly detected prediabetes (impaired fasting glucose [IFG] and impaired glucose tolerance [IGT] alone in 36 and 10 patients respectively and both IFG and IGT in a further 17) and DM was diagnosed in 9 (4%) patients (fasting blood glucose [FBG] ≥ 126 mg/dl in 1 and both FBG ≥ 126 mg/dl and 2-h plasma blood glucose [PLBG] ≥ 200 mg/dl in 8 patients). The total prevalence of (newly diagnosed) DM and prediabetes, therefore, was 32% (72 patients); the overall prevalence of DM was 30% (94 patients). Conclusions This study found high prevalence of prediabetes and diabetes among patients with TB. This underscores the need for a bidirectional screening strategy to improve diagnosis and outcome of both TB and DM.

Prevalence of type 2 diabetes and pre‐diabetes among pulmonary and extrapulmonary tuberculosis patients of Bangladesh: A cross‐sectional study

“…The study showed that people with PTB were more affected by T2D or hyperglycaemia. The result was consistent with other epidemiological studies conducted in India, 25 , 26 , 27 Mexico 28 and Vietnam. 29 In these studies, the prevalence of diabetic patients with PTB and EPTB ranges from 15% to 35% and 8% to 26%, respectively.…”

“…The result was consistent with other epidemiological studies conducted in India, 25‐27 Mexico 28 and Vietnam 29 . In these studies, the prevalence of diabetic patients with PTB and EPTB ranges from 15% to 35% and 8% to 26%, respectively 25‐29 . A cross‐sectional study conducted in Bangladesh also identified that PTB patients made eighty‐five per cent of the burden of diabetes in the TB population 14 .…”

“… 29 In these studies, the prevalence of diabetic patients with PTB and EPTB ranges from 15% to 35% and 8% to 26%, respectively. 25 , 26 , 27 , 28 , 29 A cross‐sectional study conducted in Bangladesh also identified that PTB patients made eighty‐five per cent of the burden of diabetes in the TB population. 14 However, it was uncertain why people with PTB faced a high prevalence of T2D.…”

Gradient association between pulmonary tuberculosis and diabetes mellitus among households with a tuberculosis case: a contact tracing-based study

“…In accordance with a systematic review of 13 observational studies, DM was associated with an increased risk of PTB (relative risk = 3.11, 95% CI 2.27–4.26) 3 . In an Indian study, among the 313 PTB subjects, the prevalence of newly diagnosed DM and prediabetes was 32% and the overall prevalence of DM was 30% 4 . In Bangladesh, among the 1910 PTB patients who participated in screening for diabetes, 245 (12.8%) were found to have diabetes and 296 (15.5%) to have prediabetes 5 .…”