Prevalence of Diabetes Mellitus in Newly Diagnosed Tuberculosis Patients
DOI:
https://doi.org/10.63682/jns.v14i19S.4811Keywords:
Tuberculosis, Diabetes Mellitus, Prevalence, Comorbidity, ScreeningAbstract
Background: Tuberculosis (TB) and diabetes mellitus (DM) are significant global health challenges, with emerging evidence suggesting a bidirectional relationship between the two conditions. The coexistence of DM in TB patients can complicate treatment outcomes, increase relapse rates, and exacerbate disease severity. This study aims to determine the prevalence of diabetes mellitus in newly diagnosed tuberculosis patients and explore associated risk factors.
Methods: A cross-sectional study was conducted among newly diagnosed TB patients at government multispecialty hospital, Sector 16, Chandigarh. Patients were screened for DM using fasting blood glucose, HbA1c, or random blood glucose tests as per WHO guidelines. Demographic data, clinical characteristics, and risk factors such as age, body mass index (BMI), family history of DM, and socioeconomic status were collected. Prevalence was calculated, and logistic regression analysis was used to identify factors associated with DM in TB patients.
Results: In our study participants of 152 newly diagnosed TB patients, 21.7% were found to have diabetes mellitus. Among these, 6.5 % were newly diagnosed with DM, while 15.1 % had a prior DM diagnosis. Factors significantly associated with DM prevalence included older age showed high significance (p<0.001), higher BMI (p<0.05), and history of smoking (p<0.05). And there is a significant association that was observed with gender (p<0.35).
Conclusion: The high prevalence of diabetes mellitus in newly diagnosed TB patients underscores the need for routine DM screening in TB management programs. Early detection and management of DM in TB patients could improve treatment outcomes and reduce complications. Further studies are warranted to assess the impact of integrated TB-DM care on long-term health outcomes.
Downloads
Metrics
References
Anchit, Bhushan, A., & Srinivasa, B. (2023). Effect of Metformin Monotherapy and Combination Therapy with Glimepiride on Lipid Profile in Drug Naive Type-2 Diabetes Patients: A Prospective Observational Study. Journal of Pharmaceutical Care. https://doi.org/10.18502/jpc.v11i1.12633
Bailey, S., & Grant, P. (2011). ‘The tubercular diabetic’: the impact of diabetes mellitus on tuberculosis and its threat to global tuberculosis control. Clinical Medicine, 11(4), 344. https://doi.org/10.7861/clinmedicine.11-4-344
Chopra, V., Virk, B. S., Chopra, S., Bansal, M., & Chungath, J. T. (2020). Application of CBNAAT (Xpert MTB/RIF assay) in new smear negative pulmonary tuberculosis patients. Monaldi Archives for Chest Disease, 90(1). https://doi.org/10.4081/monaldi.2020.1146
Chudamani, P. (2020). Comparative study of pulmonary tuberculosis in diabetics and non-diabetics. International Journal of Advanced Research in Medicine, 2(2), 282. https://doi.org/10.22271/27069567.2020.v2.i2d.243
Datta, B., Ford, D., Goyal, P., Prakash, A., Tripathy, J. P., Gnanashanmugam, D., Mishra, S. K., Aggarwal, A., Kotalwar, S., Mittal, S., Mangla, A., Jaiswal, A., & Trehan, N. (2020). Mobile digital x-ray and portable cartridge based nucleic acid amplification test machines for point-of-care diagnosis of TB in rural India. Transactions of the Royal Society of Tropical Medicine and Hygiene, 115(8), 937. https://doi.org/10.1093/trstmh/traa152
Dutt, C., Salles, J. E. N., Joshi, S., Nair, T., Chowdhury, S., Mithal, A., Mohan, V., Kasliwal, R. R., Sharma, S., Tijssen, J., & Tandon, N. (2022). Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries [Review of Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries]. Diabetes Metabolic Syndrome and Obesity, 451. Dove Medical Press. https://doi.org/10.2147/dmso.s333787
Feyisa, B. R., Mosisa, G., Biru, B., Debelo, S., & Dufera, M. (2022). Community-Based Findings of Magnitude of Type 2 Diabetes Mellitus among Adults in Selected Towns of Western Ethiopia. Dubai Diabetes and Endocrinology Journal, 28(2), 56. https://doi.org/10.1159/000522563
Habtewold, T. D., Tsega, W. D., & Wale, B. Y. (2016). Diabetes Mellitus in Outpatients in Debre Berhan Referral Hospital, Ethiopia. Journal of Diabetes Research, 2016, 1. https://doi.org/10.1155/2016/3571368
Holtz, T. H. (n.d.). Tuberculosis: epidemiology. Retrieved April 16, 2025, from https://www.sciencedirect.com/science/article/pii/B9780123739605002240
Kautzky‐Willer, A., Harreiter, J., & Pacini, G. (2016). Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus [Review of Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus]. Endocrine Reviews, 37(3), 278. Oxford University Press. https://doi.org/10.1210/er.2015-1137
Kerama, C., Horné, D., Ong’ang’o, J. R., & Anzala, O. (2023). Rethinking the syndemic of tuberculosis and dysglycaemia: a Kenyan perspective on dysglycaemia as a neglected risk factor for tuberculosis [Review of Rethinking the syndemic of tuberculosis and dysglycaemia: a Kenyan perspective on dysglycaemia as a neglected risk factor for tuberculosis]. Bulletin of the National Research Centre/Bulletin of the National Research Center, 47(1). Springer Science+Business Media. https://doi.org/10.1186/s42269-023-01029-6
Kerama, C., Horné, D., Ong’ang’o, J. R., & Anzala, O. (2023). Rethinking the syndemic of tuberculosis and dysglycaemia: a Kenyan perspective on dysglycaemia as a neglected risk factor for tuberculosis [Review of Rethinking the syndemic of tuberculosis and dysglycaemia: a Kenyan perspective on dysglycaemia as a neglected risk factor for tuberculosis]. Bulletin of the National Research Centre/Bulletin of the National Research Center, 47(1). Springer Science+Business Media. https://doi.org/10.1186/s42269-023-01029-6
Kubiak, R. W., Sarkar, S., Horsburgh, C. R., Roy, G., Kratz, M., Reshma, A., Knudsen, S., Salgame, P., Ellner, J. J., Drain, P. K., & Hochberg, N. S. (2019). Interaction of nutritional status and diabetes on active and latent tuberculosis: a cross-sectional analysis. BMC Infectious Diseases, 19(1). https://doi.org/10.1186/s12879-019-4244-4
Kumari, M., & Singh, R. kumar. (2020). Evaluation of safety and efficacy of glimepiride and sitagliptin in combination with metformin in patients with type 2 diabetes mellitus: Analytical study.
Kumari, M., & Singh, R. kumar. (2020). Evaluation of safety and efficacy of glimepiride and sitagliptin in combination with metformin in patients with type 2 diabetes mellitus: Analytical study.
Kumbar, A. S., Faseed, M., & D.S, H. (2021). Pattern of chest radiographic abnormalities and co-morbidities in newly detected sputum positive pulmonary tuberculosis cases. Indian Journal of Immunology and Respiratory Medicine, 6(1), 10. https://doi.org/10.18231/j.ijirm.2021.003
Läll, K., Mägi, R., Morris, A. P., Metspalu, A., & Fischer, K. (2016). Personalized risk prediction for type 2 diabetes: the potential of genetic risk scores. Genetics in Medicine, 19(3), 322. https://doi.org/10.1038/gim.2016.103
Laxmi, S. B., Kandikonda, S. H., Vemuri, J. L. N., & Rao, R. L. L. (2019). A study on prevalence of diabetes mellitus among adult tuberculosis patients in tertiary health care centre, Hyderabad. International Journal of Community Medicine and Public Health, 6(3), 1225. https://doi.org/10.18203/2394-6040.ijcmph20190616
Naghipour, A., Khatirnamani, Z., Kalteh, E. A., & Taramian, S. (2021). Prevalence of Tuberculosis in Diabetic Patients Living in Rural Areas of Northern Iran in 2016. Journal of Guilan University of Medical Sciences, 29(4), 114. https://doi.org/10.32598/jgums.29.4.1
Okemah, J., Peng, J., & Quiñones, M. J. (2018). Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review [Review of Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review]. Advances in Therapy, 35(11), 1735. Adis, Springer Healthcare. https://doi.org/10.1007/s12325-018-0819-5
Olokoba, A. B., Obateru, O. A., & Olokoba, L. B. (2012). Type 2 Diabetes Mellitus: A Review of Current Trends [Review of Type 2 Diabetes Mellitus: A Review of Current Trends]. Oman Medical Journal, 27(4), 269. Oman Medical Specialty Board. https://doi.org/10.5001/omj.2012.68
Ong, K. L., Stafford, L. K., McLaughlin, S. A., Boyko, E. J., Stein, D. J., Smith, A., Dalton, B., Duprey, J., Cruz, J. A., Hagins, H., Lindstedt, P. A., Aali, A., Abate, Y. H., Abate, M. D., Abbasian, M., Abbasi-Kangevari, Z., Abbasi‐Kangevari, M., ElHafeez, S. A., Abd‐Rabu, R., … Azadnajafabad, S. (2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10397), 203. https://doi.org/10.1016/s0140-6736(23)01301-6
Pappachan, J. M. (2021). Efficacy and Cardiovascular Safety of Antidiabetic Medications. In Current Drug Safety (Vol. 16, Issue 2, p. 115). Bentham Science Publishers. https://doi.org/10.2174/1574886316666210112153429
Patel, B. K., Gochhait, D., Dhandapani, K., Jamir, T. S., Edura, P., Parepalli, D., & Siddaraju, N. (2023). Bacillary Positive Tuberculous Body Fluid Smears: A Perspective on How Fast to Use Acid Fast. Cureus. https://doi.org/10.7759/cureus.38447
Patil, S., Nishat, S. A., & Dharapur, P. (2023). Comparing the effect of Sitagliptin versus Glimepiride on lipid profile and BMI in known case of Type 2 Diabetes Mellitus.
Phelan, J. J., Basdeo, S. A., Tazoll, S. C., McGivern, S., Saborido, J. R., & Keane, J. (2018). Modulating Iron for Metabolic Support of TB Host Defense [Review of Modulating Iron for Metabolic Support of TB Host Defense]. Frontiers in Immunology, 9. Frontiers Media. https://doi.org/10.3389/fimmu.2018.02296
Pokharel, D. R., Gautam, N., Archana, J., Nagamma, T., Kumar, R., & Sapkota, R. M. (2012). Frequency of Type 2 Diabetes mellitus and Impaired Glycemia in a Teaching Hospital of South-Western Nepal. Asian Journal of Medical Sciences, 2(3), 202. https://doi.org/10.3126/ajms.v2i3.5485
Prezzemolo, T., Guggino, G., Manna, M. P. L., Liberto, D. D., Dieli, F., & Caccamo, N. (2014). Functional Signatures of Human CD4 and CD8 T Cell Responses to Mycobacterium tuberculosis [Review of Functional Signatures of Human CD4 and CD8 T Cell Responses to Mycobacterium tuberculosis]. Frontiers in Immunology, 5. Frontiers Media. https://doi.org/10.3389/fimmu.2014.00180
Restrepo, B. I. (2007, July 25). Convergence of the Tuberculosis and Diabetes Epidemics: Renewal of Old Acquaintances. In Clinical Infectious Diseases (Vol. 45, Issue 4, p. 436). Oxford University Press. https://doi.org/10.1086/519939
Roden, M., & Shulman, G. I. (2019). The integrative biology of type 2 diabetes [Review of The integrative biology of type 2 diabetes]. Nature, 576(7785), 51. Nature Portfolio. https://doi.org/10.1038/s41586-019-1797-8
Tarachandani, D., Singhal, K., Goyal, A., Joshi, A., & Joshi, R. (2023). Quantum of Stress Hyperglycemia at the Time of Initial Diagnosis of Tuberculosis. Cureus. https://doi.org/10.7759/cureus.36382
Tarachandani, D., Singhal, K., Goyal, A., Joshi, A., & Joshi, R. (2023). Quantum of Stress Hyperglycemia at the Time of Initial Diagnosis of Tuberculosis. Cureus. https://doi.org/10.7759/cureus.36382
Vashishtha, V. M. (2010). Current status of tuberculosis and acute respiratory infections in India: Much more needs to be done! Indian Pediatrics, 47(1), 88. https://doi.org/10.1007/s13312-010-0005-6
Wu, Y., Ding, Y., Tanaka, Y., & Zhang, W. (2014). Risk Factors Contributing to Type 2 Diabetes and Recent Advances in the Treatment and Prevention [Review of Risk Factors Contributing to Type 2 Diabetes and Recent Advances in the Treatment and Prevention]. International Journal of Medical Sciences, 11(11), 1185. Ivyspring International Publisher. https://doi.org/10.7150/ijms.10001
Yorke, E., Atiase, Y., Akpalu, J., Sarfo‐Kantanka, O., Boima, V., & Dey, I. D. (2017). The Bidirectional Relationship between Tuberculosis and Diabetes [Review of The Bidirectional Relationship between Tuberculosis and Diabetes]. Tuberculosis Research and Treatment, 2017, 1. Hindawi Publishing Corporation. https://doi.org/10.1155/2017/1702578
Yorke, E., Atiase, Y., Akpalu, J., Sarfo‐Kantanka, O., Boima, V., & Dey, I. D. (2017). The Bidirectional Relationship between Tuberculosis and Diabetes [Review of The Bidirectional Relationship between Tuberculosis and Diabetes]. Tuberculosis Research and Treatment, 2017, 1. Hindawi Publishing Corporation. https://doi.org/10.1155/2017/1702578
Yvonne, O. (2013). Diabetes Mellitus in Developing Countries and Case Series. In InTech eBooks. https://doi.org/10.5772/50658
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
