A comparative study of clinical profile of diabetic tuberculosis patients with non diabetic tuberculosis patients of outpatient department of tertiary healthcare centre

Prachi Chikhalikar; M. V. Bansode; Anita Paritekar; Varun Bafna

doi:10.18203/2320-6012.ijrms20241542

Authors

Prachi Chikhalikar Department of Medicine, RCSM GMC & CPR Hospital, Kolhapur, Maharashtra, India
M. V. Bansode Department of Medicine, RCSM GMC & CPR Hospital, Kolhapur, Maharashtra, India
Anita Paritekar Department of Medicine, RCSM GMC & CPR Hospital, Kolhapur, Maharashtra, India
Varun Bafna Department of Medicine, RCSM GMC & CPR Hospital, Kolhapur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241542

Keywords:

Diabetic tuberculosis, Elderly, Lower lobe involvement, Multidrug resistance, Prolonged intensive phase

Abstract

Background: The global increase in type 2 DM is recognized re-emerging risk and challenge to TB control in India. TB-T2D association is again at the frontline of risk factors for TB, with an estimated worldwide population attributable fraction of 34.5%. T2D not only increases TB risk 3-fold, but also TB treatment failure including death. And prognosis of diabetic tuberculosis patients as compared to non diabetic ones is poorer.

Methods: An comparative analytical study was done in microbiologically confirmed 50 diabetic and 50 non diabetic TB patients registered in RNTCP OPD of tertiary healthcare hospital who were followed up for 3 months.

Results: In our study we found that elderly (above 65 age group) male diabetic patients were affected more with tuberculosis as compared to young patients and data was statistically significant. Extrapulmonary involvement was seen more in diabetic patients as compared to non diabetic patients. Radiologically diabetic tuberculosis patient showed predominantly lower lobe of lung involvement as oppose to non diabetic tuberculosis patients who showed upper lobe of lung involvement and data was statistically significant. Outcomes like Multidrug Resistance and prolonged sputum positivity after intensive phase treatment was seen more with diabetic tuberculosis patients but this was not statistically significant.

Conclusions: Early screening of TB patients for DM and vice versa and early initiation of treatment will prevent unfavourable outcomes of these patients.

Metrics

Metrics Loading ...

References

Restrepo BI. Diabetes and Tuberculosis. Microbiol Spectr. 2016;4(6):10.

Restrepo BI, Scordo JM, Aguillón-Durán GP, Ayala D, Quirino-Cerrillo AP, Loera-Salazar R, et al. Differential role of type 2 diabetes as a risk factor for tuberculosis in the elderly versus younger adults. Pathogens. 2022;11(12):1551.

Tatar D, Senol G, Alptekin S, Karakurum C, Aydin M, Coskunol I. Tuberculosis in diabetics: features in an endemic area. Japan J Infect Dis. 2009;62(6):423-7.

Kim SJ, Hong YP, Lew WJ, Yang SC, Lee EG .Incidence of pulmonary tuberculosis among diabetic. Tuber Lung Dis. 1995;76:529-33.

India Tuberculosis-Diabetes Study Group. Screening of patients with tuberculosis for diabetes mellitus in India. Trop Med Int Health. 2013;18(5):636-45.

Bashar M, Alcabes P, Rom WN, Condos R. Increased incidence of multidrug -resistant tuberculosis in diabetic patients on the Bellevue chest service 1987 to 1997.Chest. 2001;120:1514-9.

Cheng P, Wang L, Gong W. Cellular immunity of patients with tuberculosis combined with diabetes. J Immunol Res. 2022;2022:6837745.

Miller PB, Zalwango S, Galiwango R, Kakaire R, Sekandi J, Steinbaum L, et al. Association between tuberculosis in men and social network structure in Kampala, Uganda. BMC Infect Dis. 2021;21:1-9.

Negin J, Abimbola S, Marais BJ. Tuberculosis among older adults–time to take notice. Int J Infect Dis. 2015;32:135-7.

Magee MJ, Foote M, Ray SM, Gandhi NR, Kempker RR. Diabetes mellitus and extrapulmonary tuberculosis: site distribution and risk of mortality. Epidemiol Infect. 2016;144(10):2209-16.

Singh A. Radiographic findings in tuberculous diabetic patients. Lung India. 2011;28(1):71.

Mave V, Gaikwad S, Barthwal M, Chandanwale A, Lokhande R, Kadam D, Dharmshale S, et al. Diabetes Mellitus and Tuberculosis Treatment Outcomes in Pune, India. Open Forum Infect Dis. 2021;8(4):ofab097.

Stevenson CR, Foroushi NG, Roglic G, Williams BG, Lauer JA, Dye C, et al. Diabetes and tuberculosis the impact ofdiabetes epidemic on tuberculosis incidence. BMC Publ Heal. 2007;7:234.

Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006;10(3):191-9.

Singla R, Khan N. Does diabetes predispose to the development of multidrug resistant tuberculosis. Chest. 2003;123(1):308-9.

Marais RM. Diabetes mellitus in black and coloured tuberculosis patients. S Afr Med J. 1980;57(13):483-4.

Ikezoe J, Takeuchi N, Johkoh T, Kohno N, Tomiyama N, Kozuka T, et al. CT appearance of pulmonary tuberculosis in diabetic and immunocompromised patients: comparison with patients who had no underlying disease. AJR Am J Roentgenol. 1992;159(6):1175-9.

Morris JT, Seaworth BJ, McAllister CK. Pulmonary tuberculosis in diabetics. Chest. 1992;102(3):539-41.

Bacakoglu F, Basoglu OK, Cok G, Sayiner A, Ates M. Pulmonary tuberculosis in patients with diabetes mellitus. Respiration. 2001;68(6):595-600.

Perez-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(6):455-61.

Weaver RA. Unusual radiographic presentation of pulmonary tuberculosis in diabetic patients. Am Rev Respir Dis. 1974;109(1):162-3.