Relationship between diabetes mellitus and pulmonary tuberculosis and the outcome of treatment
DOI:
https://doi.org/10.18203/2349-3933.ijam20162201Keywords:
Tuberculosis, Diabetes mellitus, Coinfection, Hb1AcAbstract
Background: Diabetes mellitus (DM) TB co-infection is associated with poor glycemic control in DM patients. The dual curse of these two diseases may have an impact on the outcome of treatment.
Methods: 72 out of 164 patients above 18 years of age were had Diabetes mellitus and 92 of them were non diabetic. Demographic details, physical and clinical examination, Blood tests for Hb1Ac, chest x rays, and sputum for AFB were done for all the patients. Antitubercular treatment was given for all of them. To the diabetics, in addition to the ATT, anti-diabetic drugs were also given. Follow up was done after 2 and 6 months.
Results: The most common age group to be affected was 55-64 years among the diabetic group and 45-54 among the non-diabetic group. Most of the patients with diabetes had an elevated HbA1c levels which was significantly prominent among 35-64 years of age group. Most of the diabetics had 3+ sputum positivity. 54.2% had far advanced severity on chest X-rays. Sputum conversion was seen in 77.7% of the cases among the diabetic patients, 16.7% of these patients had failed treatment and 2 of the persons died during the study period.
Conclusions: Screening for DM in patients with TB could improve case detection, early treatment, and prevention of DM complications.
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References
Lennroth K, Raviglione M.: Global epidemiology of tuberculosis: prospects for control. Semin Respic Crit Care Med. 2008;29:481-91.
World Health Organization: Global tuberculosis control 2009: epidemiology strategy, financing – Geneva, Switzerland; 2010. Available at http://www.who.int / tb / publications /global- report / 2009 / en, Accessed on 10 June, 2016.
Global TB Report 2012. World Health Organization. 2012. Available at http://www.who.int/tb/publications/global_report/en/ Accessed on 25th September 2013.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-53.
Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance. In: Gan D, editor. Diabetes Atlas. International Diabetes Federation. 3rd ed. Belgium: International Diabetes Federation; 2006:15-103.
Restrepo BI. Convergence of the tuberculosis and diabetes epidemics: Renewal of old acquaintances. Clin Infect Dis. 2007;45:436-8.
García-Elorriaga G, Del Rey-Pineda G. Type 2 diabetes mellitus as a risk factor for tuberculosis. J Mycobac Dis. 2014;4(2):144.
Bacakoglu F, Basoglu OO, Cok G, Sayiner A, Ates M. Pulmonary tuberculosis in patients with diabetes mellitus. Respiration. 2001;68(6):595-600
Mboussa J, Monabeka H, Kombo M, Yokolo D, Yoka-Mbio A, Yala F. Course of pulmonary tuberculosis in diabetics. Rev Pneumol Clin. 2003;59(1):39-44.
Balakrishnan S, Vijayan S, Nair S, Subramaniapillai J, Mrithyunjayan S, , Wilson N, et al. High diabetes prevalence among tuberculosis cases in Kerala, India. PloS One 2012;7(10):e46502.
Vishwanathan AA, Gawde NC. Effect of type II diabetes mellitus on treatment outcomes of tuberculosis. Lung India. 2014;31(3):244-8.
Ruslami R, Aarnoutse RE, Alisjahbana B, van der Ven AJ, Van Crevel R. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop Med Int Health. 2010;15(11):1289-99.
Singla R, Khan N, Al-Sharif N, Ai-Sayegh MO, Shaikh MA, Osman MM. Influence of diabetes on manifestations and treatment outcome of pulmonary TB patients. Int J Tuberc Lung Dis. 2006;10(1):74-9.
Pérez-Guzman C, Torres-Cruz A, Villarreal-Velarde H, Salazar-Lezama MA, Vargas MH. Atypical radiological images of pulmonary tuberculosis in 192 diabetic patients: A comparative study. Int J Tuberc Lung Dis. 2001;5:455-61.
Samir B. Al-Adhami, Basim S. Al-Mgoter. Pulmonary Tuberculosis in Patients with Diabetes Mellitus. Iraqi J. Comm. Med. 2008;21(1):47-54.
Patel JC, Ugini SS. Diabetes and tuberculosis. Ind J Tub.1977;XXIV (4):155-8.
Kim SJ, Hong YP, Lew WJ, Yang SC, Lee EG. Incidence of pulmonary tuberculosis among diabetics. Tuberc Lung Dis. 1995;76:529-33.
Guptan ASA: Tuberculosis and diabetes: an appraisal. Ind J Tub. 2000;47:3-8.
Alisjahbana B, van Crevel R, Sahiratmadia E, den Heijer M, Maya A, Istriana E, et al. Diabetes mellitus is strongly associated with tuberculosis in Indonesia. Int J Tuberc Lung Dis. 2006;10(6):696-700.
Chiang CY, Lee JJ, Chien ST, Enarson DA, Chang YC, Chen YT, et al. Glycemic control and radiographic manifestations of tuberculosis in diabetic patients. PLoS One. 2014;9:e93397.
Avuthu S, Mahishale V, Patil B, Eti A. Glycemic control and radiographic manifestations of pulmonary tuberculosis in patients with type 2 diabetes mellitus. Sub-Saharan Afr J Med. 2015;2:5-9
Park SW, Shin JW, Kim JY, Park IW, Choi BW, Choi JC, et al. The effect of diabetic control status on the clinical features of pulmonary tuberculosis. Eur J Clin Microbiol Infect Dis. 2012;31:1305-10.