Screening for diabetes mellitus in patients diagnosed with pulmonary tuberculosis

ABSTRACT

BACKGROUND: The epidemic of diabetes mellitus (DM) poses a threat for global tuberculosis (TB) control.   OBJECTIVE: This study attempts to assess the value of screening for diabetes in patients with pulmonary tuberculosis and reviews the disease burden, clinical and radiographic manifestations,rates of sputum smear positivity and time to conversion,treatment outcomes and fatality rates,in the local setting.METHODS: This is a prospective observational cohort study involving adults diagnosed with pulmonary tuberculosis at the PTSI TB DOTS out-patient clinic, regardless of sputum-smear status, from July 2011-November 2012. A diabetes screening tool was used and patients were screened for presence of DM. Treatment outcomes were also determined.RESULTS: Of the 38 patients enrolled, seven (18.4%,95% confidence interval 7.7-34.3) were diagnosed with DM. This is higher than the estimated 12.9% in 2010 and 14.4% projected estimate in 2030 in our country by a report of WHO as well as in reported prevalence of DM among patients with PTB in large studies done in China (12.4%) and India (13%). There was no significant difference noted in the basic profile,clinical and radiographic presentation,sputum conversion and treatment outcomes among patients with DM and without DM who were being treated for PTB.CONCLUSION: This study demonstrates the value and feasibility of screening for DM among patients with PTB. Although the findings of this study are consistent with most of previous similar studies, the estimate on the true prevalence of DM may not be very accurate because of the small sample size. Hence,a multi-center study with a larger sample size must be conducted to more accurately measure the true prevalence of DM among patients with TB and to determine associations of various clinical and radiographic presentations and clinical outcomes.