59% while the NNS to detect a new case of DM was 18. Theprevalence of DM among patients who were older than 40 years was far higherthan among younger persons; sex on the other hand was not associated with the occurrenceof DM. The additional yield of DM was greater among older patients, persons whosought care at a public facility, rural residents and HIV-negative persons.
Inall, factors favouring occurrence of DM among TB patients in the study groupwere older age (over 40 years), private facility care and rural residence.Conversely, patients engaged in occupations with vigorous activity were lesslikely have DM. In this study we found a high prevalence of DM among the TBpatients (11.
9%) treated in Bhopal; and it was higher among those with age>50 years, male gender, smokers, patients having high BMI range (>25),type II treatment category and those with Pulmonary tuberculosis as compared toage <50, female gander, non smokers, BMI range <25, type I treatmentcategory and extra pulmonary tuberculosis.Inpresent study the prevalence of diabetes among tuberculosis patients was 11.9%and that of pre diabetes was 15.3 %. Similar results were reported in earlierstudies by Singla et al.,10 Raghuraman etal.,11 Khanna et al.
,12 A.Kumaret al 2013 13 andBalakrishnan et al. 14Zhang Q et al. 2009,15 with 25%, 29%,14.5%,13% and 44% 9.5%, prevalence of diabetesamong TB patients.
Thisstudy found a significantly higher prevalence of DM in older TB patients(age>50). Similar finding have been reported by studies from other parts ofIndia and others contries16171819. Thisstudy also reported the higher association of DM and PTB, which is alsoreported in many studies including those by Zhang et al.15 and Guptan andShah18. This studyhas reported significantly higher prevalence of DM among male gender, which issupported by that reported in the study conducted in south India 20.Result of the current studyshows that diabetes among alcoholic tuberculosis patients to be more as compareto non alcoholic patients, and the difference was not significant. Similarresult seen earlier study 21 11shows that Alcohol consumption was found to be a risk factor for diabetes in TBpatients.
The present study shows that diabeteswas more common among TB patients with BMI more 25 (19.0%) as compare to thosewith BMI <25 (9.04%) and the difference was statistically significant(P=0.
001). Similar result was seen earlier by Soudarnjan R (2014)11. In current study we found that diabetes among tuberculosiswas significantly more among type II category tuberculosis patients as compareto Type I treatment category tuberculosis.
Finding of this study was supported by earlier study 22,23.In current study we foundthat smoker tuberculosis patients have significantly more diabetes (16.3%) ascompared to non smoker tuberculosis patients (9.8%) (p=0.0001). Similar resultwas found in earlier study 24,25.
The NNS to detect a new case of DM among TB patients was22. This number varies in from lower toamong study from south India may we due to higher prevalence of diabetesmellitus. we found that NNS needed to detect one case of DM amongTB patients decreases as the age increases14,26.Thisshows the importance of early screening of patients with TB and will enable usto manage these patients in the early phase. Pre-diabetes diagnose at earlyphase so that primary prevention methods may be initiated timely. As we higherburden of both TB and DM in our country, We need better information, recordingand monitoring system to guide us in managing this co-morbidity, and we need tostrengthen the care of these patients in our existing health services.
Ourstudy had several strengths. The strength ofthis study is that we implement this screening programme in routine programmesettings. We also emphasis on the NNNS todiagnose a new case of DM with respect to different variables so we can focuson the lower value of NNS for screening on large scale. There were a fewlimitations like previous documentation of blood sugar not cross check.
Meantime for sugar testing and disease duration was not same for each tuberculosispatients.