Metabolic risk in drug-resistant tuberculosis: prevalence of type 2 diabetes and its association with disease severity

Amita Mason; Rakhee Khanduri; Sohaib Ahmed; Rahul Kumar Gupta; Manoj Kumar; Varuna Jethani; Sushant Khanduri

doi:10.18203/2320-6012.ijrms20260952

Authors

Amita Mason Department of Respiratory Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Rakhee Khanduri Department of Respiratory Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Sohaib Ahmed Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Rahul Kumar Gupta Department of Respiratory Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Manoj Kumar Department of Respiratory Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Varuna Jethani Department of Respiratory Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Sushant Khanduri Department of Respiratory Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20260952

Keywords:

Drug-resistant tuberculosis, Type 2 diabetes mellitus, Clinical profile, Radiological findings

Abstract

Background: Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a global health challenge, further complicated by the co-prevalence of Type 2 Diabetes Mellitus (T2DM), particularly in drug-resistant TB (DR-TB) cases. This dual burden worsens clinical severity, leads to poor treatment outcomes, and prolongs infectivity. This study assessed the prevalence of T2DM among DR-TB patients and evaluated clinical-radiological correlations, alongside the relationship between HbA1c and 7-point glucose profiles.

Methods: A cross-sectional study of 104 microbiologically confirmed DR-TB patients. Diabetes was diagnosed using ADA criteria. Demographics, clinical features, radiology, HbA1c, and 7-point glucose profiles were analyzed.

Results: T2DM prevalence was 41.3% in DR-TB patients, with significant associations found between T2DM, older age, and higher BMI. Radiological abnormalities included infiltrates (32.7% upper, 32.7% middle zones), consolidation (30.8%), and cavities (20.2%). No significant association was found between diabetes and radiographic extent (p> 0.05). HbA1c demonstrated a strong positive correlation with mean 7-point glucose values (r=0.579; p=0.03).

Conclusions: T2DM is highly prevalent among DR-TB patients. Routine screening and integrated TB–diabetes care are essential. HbA1c remains reliable for diagnosis and monitoring even during active TB disease.

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