Low prevalence of diabetes mellitus in patients with tuberculosis in Cotonou, Benin

Adè, S.; Affolabi, Dissou; Agodokpessi, G.; Wachinou, P.; Faïhun, F.; Toundoh, N.; Bekou, Wilfried; Makpenon, A.; Alcalá-Cerra, Gabriel; Anagonou, S.; Harries, Anthony

doi:10.5588/pha.14.0110

Cited by 18 publications

(29 citation statements)

References 7 publications

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“…The two ‘suspected’ diabetic patients were, however, not confirmed as having diabetes. In a cross-sectional study conducted in West Africa, participants displayed a 5% IFG and a 1.9% DM rate, which is comparable with the current study despite differing inclusion criteria [ 67 ]. A retrospective study performed in Sri Lanka found 7.1% pre-existing DM among their study sample, as well as 20% IFG and 2% DM rates (although lower fasting glucose cut-off values were used) [ 68 ].…”

Section: Discussionsupporting

confidence: 84%

The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study

et al. 2017

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BackgroundThe existence of a bi-directional relationship between tuberculosis (TB) and insulin resistance (IR)/diabetes has been alluded to in literature. Although diabetes has been linked to increased tuberculosis risk, the relationship between tuberculosis as a causative factor for IR remains unclear. The study aimed to determine if an association existed between tuberculosis and IR development in adults with newly diagnosed pulmonary tuberculosis at baseline. It was additionally aimed to document changes in IR status during TB follow-up periods.MethodsThis cross-sectional study evaluated ambulatory participants at baseline for IR prevalence via anthropometry, biochemistry and diagnostic IR tests [homeostasis model assessment-IR (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI)]. A prospective cohort sub-section study was additionally performed on approximately half of the baseline study population, who were followed-up at two and five months whilst on tuberculosis treatment. Summary statistics, correlation co-efficients and appropriate analysis of variance were used to describe and analyse data. Participants were excluded if they presented with other forms of tuberculosis, were HIV-positive, obese or had any pre-disposing IR conditions such as diabetes or metabolic syndrome.ResultsFifty-nine participants were included from August 2013 until December 2014 (33.95 ± 12.02 years old; 81.4% male). IR prevalence was 25.4% at baseline, determined by a calculated HOMA-IR cut-off point of 2.477. Patients with IR were younger (p = 0.04). Although the difference between IR levels in participants between baseline and follow-up was not significant, a decrease was observed over time. The majority of participants (61.0%) presented with a normal BMI at baseline. Mean baseline values of fasting glucose were within normal ranges (4.82 ± 0.80 mmol/L), whereas increased mean CRP levels (60.18 ± 50.92 mg/L) and decreased mean HDL-cholesterol levels (males: 0.94 ± 0.88 mmol/L; females: 1.14 ± 0.88 mmol/L) were found.ConclusionsThe study found an association between tuberculosis and IR development in newly diagnosed pulmonary tuberculosis patients. Although not significant, IR levels decreased over time, which could be indicative of a clinical improvement. A high prevalence of IR amongst young tuberculosis patients therefore highlights the need for early identification in order to facilitate a reversal of IR and prevent possible IR-related complications.

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Section: Discussionsupporting

confidence: 84%

The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study

et al. 2017

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“…This systematic review had analysed 78 studies reporting DM prevalence among TB patients, representing 33 countries globally. The prevalence of DM amongst TB patients ranged from 1.9% in Cotonou-Benin to 45% in the Ebeye-Mashall Islands [ 18 , 19 ]. Our study results are comparable with the overall median prevalence of DM among TB patients in Asia, estimated to be 17% (IQR 11.4–25.8%).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and associated factors of diabetes mellitus among tuberculosis patients in Hanoi, Vietnam

et al. 2018

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BackgroundDiabetes mellitus (DM) is recognized as an important comorbidity for the development of tuberculosis (TB). With the increase of DM burden globally, concerns have been raised about the emerging co-epidemics of DM and TB, especially in low- and middle-income countries.MethodsA facility-based, cross-sectional study was carried out in all 30 district TB units in Hanoi, Vietnam. All eligible, diagnosed TB patients aged 15 years old or older were asked to provide consent and were screened for diabetes using fasting blood glucose (FBG). Pre-tested semi-structured questionnaires were used for collecting demographic data, lifestyle habits and clinical data. Identification of pre-diabetes or diabetes in TB patients was done in accordance to parameters set by the American Diabetes Association (2016).ResultsOf 870 eligible TB patients, 831 (95.5%) participated in the study. Of those, 241 (29%; 95%CI: 25.9–32.1%) were prediabetic and 114 (13.7%; 95%CI: 11.4–16.1%) were found to have DM. The risk of DM was higher in patients belonging to the age group 40–64 years (OR 6.09; 95%CI 2.81–13.2); or the age group 65 years or older (OR 2.65; 95%CI 1.65–4.25) or who have a family history of DM (OR 2.71; 95%CI 1.33–5.50).ConclusionsThis study demonstrated high prevalence of DM and prediabetes among TB patients in Hanoi, Vietnam. National Tuberculosis Programme needs to establish a systematic screening process for DM among TB patients.

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“…We did, however, select DCA Vantage as our preferred HbA1c test to minimise inaccuracies, as it has consistently been shown to be one of the most reliable POC HbA1c tests; 22 for example, the DCA Vantage assay is affected only by the foetal haemoglobin (HbF) variant, and not the other variants HbC, HbD, HbE and HbS. 22 Previous studies in sub-Saharan Africa have found rates of DM among TB patients varying from 1.9% to 6.7%, 9,10,32,33 and these are much higher in the Indian subcontinent. 11 Although none of these African studies used HbA1c, and the timing of screening for DM post-TB treatment initiation was at times unclear, the rates of DM were still higher than in the comparison groups or the general population, indicating a positive relationship between DM and TB.…”

Section: Discussionmentioning

confidence: 99%

Diabetes and pre-diabetes in tuberculosis patients in western Kenya using point-of-care glycated haemoglobin

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Harries

et al. 2017

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Low prevalence of diabetes mellitus in patients with tuberculosis in Cotonou, Benin

Abstract: DM may not be an important risk factor for TB in Cotonou. A larger study on TB and DM in the whole country is needed.

Cited by 18 publications

References 7 publications

The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study

The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study

Prevalence and associated factors of diabetes mellitus among tuberculosis patients in Hanoi, Vietnam

Diabetes and pre-diabetes in tuberculosis patients in western Kenya using point-of-care glycated haemoglobin

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