P Dave1, A Shah2, M Chauhan1, A M V Kumar3, A D Harries4, S Malhotra5, K Pujara1, P Patel1, M Mane1, A Thakkar1, S Bharaswadkar2, B N Sharath6, S Achanta2. 1. Department of Health, Government of Gujarat, Gandhinagar, India. 2. World Health Organization Country Office for India, New Delhi, India. 3. International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India. 4. The Union, Paris, France ; Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK. 5. All India Institute of Medical Sciences, New Delhi, India. 6. Employees State Insurance Corporation (ESIC) Medical College, Bangalore, India.
Abstract
SETTING: Anklav Tuberculosis Unit, Anand, Gujarat, India. OBJECTIVE: To determine in a cohort of TB patients 1) the prevalence of diabetes (DM) and impaired fasting glucose (IFG), 2) the time taken for diagnosis, 3) demographic and clinical factors associated with DM and IFG, and 4) the number needed to screen (NNS) for diagnosing new cases of DM and IFG. DESIGN: Descriptive study. TB patients registered between January and September 2012 were asked whether they had a history of DM. Those with unknown DM were tested for random and fasting blood glucose (FBG). FBG of ≥126 mg/dl and 110-125 mg/dl were considered indicative of DM and IFG, respectively. RESULTS: Of 556 TB patients, 553 (99%) were assessed: 36 (6.5%) had diabetes (14 had been previously diagnosed DM and 22 were newly diagnosed), and 39 (7%) had IFG. The median (interquartile range) time to DM diagnosis was 5 (1-17) days. Age ≥35 years was associated with DM. The NNS was 25 and 14 for one new case of DM and IFG, respectively, with a lower NNS in males, those aged ≥35 years, those with smear-positive pulmonary TB, retreatment patients and smokers. CONCLUSION: This pilot project shows that it is feasible and valuable to screen patients with TB for DM in a routine setting, resulting in earlier identification of DM and opportunities for better management of comorbidity.
SETTING:Anklav Tuberculosis Unit, Anand, Gujarat, India. OBJECTIVE: To determine in a cohort of TBpatients 1) the prevalence of diabetes (DM) and impaired fasting glucose (IFG), 2) the time taken for diagnosis, 3) demographic and clinical factors associated with DM and IFG, and 4) the number needed to screen (NNS) for diagnosing new cases of DM and IFG. DESIGN: Descriptive study. TBpatients registered between January and September 2012 were asked whether they had a history of DM. Those with unknown DM were tested for random and fasting blood glucose (FBG). FBG of ≥126 mg/dl and 110-125 mg/dl were considered indicative of DM and IFG, respectively. RESULTS: Of 556 TBpatients, 553 (99%) were assessed: 36 (6.5%) had diabetes (14 had been previously diagnosed DM and 22 were newly diagnosed), and 39 (7%) had IFG. The median (interquartile range) time to DM diagnosis was 5 (1-17) days. Age ≥35 years was associated with DM. The NNS was 25 and 14 for one new case of DM and IFG, respectively, with a lower NNS in males, those aged ≥35 years, those with smear-positive pulmonary TB, retreatment patients and smokers. CONCLUSION: This pilot project shows that it is feasible and valuable to screen patients with TB for DM in a routine setting, resulting in earlier identification of DM and opportunities for better management of comorbidity.
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