A comparative study of clinical variables in tuberculosis patients with coexisting diabetes

• Main Authors: Anil Kumar Agarwal, Nikhil Agarwal, Ramniwas Mahore
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Journal of Diabetology
• Subjects: Clinical symptoms; comorbidity; diabetes mellitus II; tuberculosis
• Online Access: http://www.journalofdiabetology.org/article.asp?issn=2078-7685;year=2018;volume=9;issue=3;spage=81;epage=87;aulast=Agarwal

Background: Diabetes mellitus (DM) is recognised as an important risk factor for tuberculosis (TB). India has high-TB burden, along with rising DM prevalence. Aim: This study was conducted to document the co-existence of DM and TB in persons with established TB and difference in clinical presentation. Type of Study: This was a cross-sectional, descriptive observational study conducted at selected directly observed treatment (DOT) centre in Gwalior North-Central India. Materials and Methods: A total of 550 patients of confirmed diagnosis of TB and on treatment were recruited. The study participants were screened for DM and diagnoses were made on the basis of the World Health Organization criteria. Clinical parameters were compared between persons with DM and those without DM. Results: DM/TB comorbidity was noted in 85 persons, and these made up 15.4% of the study population. Mean age was higher in DM patients with TB (43.4 ± 15.4 vs. 33.1 ± 16.2 years, P = 0.000); the mean duration of symptoms of TB with DM was more (124 ± 16.4 vs. 107.49 ± 10.3 days). Majority of the patients (63.5% dysglycaemic and 43.6% normoglycaemic TB patients) were presented with a cough with or without expectoration and significantly found more in dysglycaemic TB patients (odds ratio = 2.2, P = 0.007). The frequency of reporting symptoms was higher among dysglycaemic TB patients as compared to normoglycaemic TB patients. This difference in both groups was found to be statistically significant (P < 0.05) for pleural effusion, fever, shortness of breath, chronic abdominal pain, fatigue/weakness and in other non-specific symptoms. Conclusions: Given the substantial burden of DM and TB co-morbidity, this study makes a contribution for re-echo the need to raise awareness on screening for DM in persons with TB.