Prevalence of diabetes mellitus among tuberculosis patients in Urban Puducherry

Raghuraman, Soundararajan; Vasudevan, Kavita; Sundararajan, G.; Chinnakali, Palanivel; Panigrahi, Krishna Chandra

doi:10.4103/1947-2714.125863

Cited by 61 publications

(27 citation statements)

References 12 publications

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“…The association of increasing age with diabetes evident from the study is consistent with past studies conducted in India [17,23,24] and China [25]. Increasing age has been established to be associated with both TB and diabetes through previous studies [26,27].…”

Section: Discussionsupporting

confidence: 91%

Double Trouble: Prevalence and Factors Associated with Tuberculosis and Diabetes Comorbidity in Bangladesh

et al. 2016

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BackgroundDiabetes among tuberculosis patients increases the risk of tuberculosis treatment failure, death, and development of multidrug-resistant tuberculosis. Yet, there is no data is available in Bangladesh on the prevalence of diabetes among tuberculosis patients. The objective of the current study was to estimate prevalence and identify factors associated with tuberculosis-diabetes co-morbidity among TB patients enrolled in the Directly Observed Treatment, Short course program.MethodsA community based cross-sectional quantitative study was conducted among 1910 tuberculosis patients living in six urban and eleven rural areas among whom Oral Glucose Tolerance Test (those who fasted) and Random Blood Sugar test (those who did not fast) were performed. Besides glucose levels, data on socio-demographic information, family history of diabetes and anthropometric measurements (height and weight) were also collected.ResultAmong the 1910 TB patients who participated in screening for diabetes, 245 (12.8%) were found to have diabetes and 296 (15.5%) to have pre-diabetes. Out of those who had diabetes, 34.7% were newly diagnosed through the current study and 65.3% already knew their status. Among those who were found to have prediabetes, 27 (9.1%) had impaired Fasting Blood Glucose (FBG), 230 (77.7%) had Impaired Glucose Tolerance (IGT), and 39 (13.2%) had both Impaired FBG and IGT. Older age, higher BMI, higher education (secondary level and above), being married, participation in less active work, and family history of diabetes are associated with higher prevalence of diabetes.ConclusionWe observed a higher prevalence of diabetes and pre-diabetes in TB patients than reported previously in Bangladesh among the general population which may challenge TB and diabetes control in Bangladesh. Diabetes diagnosis, treatment and care should be integrated in the National TB Program.

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Section: Discussionsupporting

confidence: 91%

Double Trouble: Prevalence and Factors Associated with Tuberculosis and Diabetes Comorbidity in Bangladesh

et al. 2016

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“…The patients with TB-T2DM were 10 years older than those with TB only. This difference can be explained by the parallel increase of the prevalence of T2DM with age, as has been previously reported (Delgado-Sanchez et al, 2015;Hongguang et al, 2015;Perez-Navarro et al, 2015;Raghuraman, Vasudevan, Govindarajan, Chinnakali, & Panigrahi, 2014). Our study supports the concept that family history of diabetes (reported in 68% of patients with TB-T2DM, OR 5.04, IC 95% 3.4, 7.4, p< 0.001) is a risk factor for development of TB (Ogbera et al, 2015;PerezNavarro et al, 2015;Chittoor et al, 2013).…”

Section: Discussionsupporting

confidence: 90%

The effect size of type 2 diabetes mellitus on tuberculosis drug resistance and adverse treatment outcomes

Perez-Navarro

Restrepo²,

Fuentes-Domínguez³

et al. 2017

Tuberculosis

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2 AbstractObjective: To evaluate the effect size of type 2 diabetes mellitus (T2DM) on tuberculosis (TB) treatment outcomes and multi drug resistance (MDR). Methods:A cohort with 507 individuals with diagnosed TB included 183 with coexistence of T2DM and TB (TB-T2DM). Participants were identified at the time of TB diagnosis and followed during the course of TB treatment. Then we computed relative risks and adjustments by Cox proportional hazards for outcome variables (drug resistance, death, relapse, treatment failure), and the size of their effect as Cohen's-d. Results:Patients with TB-T2DM were more likely to remain positive for acid-fast bacilli after two months of anti-TB treatment RR= [2.01 (95% CI: 1.3, 3.1)], to have drug resistant (DR) [OR 3.5 (1.8, 6.7)] and multi-drug resistant (MDR) TB [OR 3.5 (1.8, 7.1)]. The Cohen's-d for DR or MDR in T2DM was 0.69 when compared with non-DM subjects. The T2DM patients had higher odds of resistance to isoniazid (OR 3.9, 95% CI 2.01, 7.9), rifampicin (OR 3.4, 95%CI: 1.6, 7.2) and pyrazinamide (OR 9.4, 95% CI 2.8, 25.6), and their effect sizes were ≥ 0.67. Patients with TB-T2DM (versus no DM) were more likely to present with MDR TB (HR 3.1; 95% CI 1.7, 5.8; p <0.001), treatment failure (HR 2.04; 95% CI 1.07, 3.8; p 0.02) and relapse (HR 2.1; 95% CI 1.2, 3.8; p 0.002), with effect sizes ≥0.39. Conclusion:T2DM showed a substantial contribution to the presence of DR or MDR-TB and to adverse clinical outcomes during and after TB treatment. Our findings support the importance for routine screening of T2DM among newly-diagnosed TB patients in order to stratify them for immediate DR assessment, and highlight the need for clinical trials to evaluate variations to the standard TB treatment in TB-T2DM to prevent adverse treatment outcomes.Keywords: Tuberculosis, type 2 diabetes mellitus, effect, size 3 IntroductionThe overall prevalence of diabetes mellitus (DM) has increased rapidly as a result of an aging population, urbanization and associated changes lifestyle during the last decades. The International Diabetes Federation (IDF) estimated in 2015 the worldwide prevalence of type 2 diabetes mellitus (T2DM) was 8.8% (415 million people) (IDF). In Mexico, the prevalence of T2DM increased by 4.7% from 1998 to 2012, with a morbidity rate of 358.2 per 100 000 in 2012 (Sistema.Nacional. de.Vigilancia.Epidemiológica, 2013). Meanwhile, the World Health Organization (WHO) reported 9.5 million new cases of TB in 2014 and 1.5 million deaths.( WHO, 2015) In Mexico, the tuberculosis (TB) incidence was 23 per 100,000, reflecting a serious public health problem (Delgado-Sanchez et al., 2015).The increase in prevalence of T2DM has had a significant impact on tuberculosis comorbidity, with prevalence rates ranging from 10% to 30%, mainly affecting developing countries, including Some studies report that T2DM increased two to three times the risk of TB (Dooley & Chaisson, 2009;Jeon & Murray, 2008;Perez-Navarro et al., 2015), and diminishes the success of treatment cure (Baker et al., 2011...

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“…[ 18 ] This result also in line with research conducted in India found that TB patients with comorbidities leading to delayed sputum conversion primarily occurred in communities with low social class. [ 29 ]…”

Section: Discussionmentioning

confidence: 99%