59% high prevalence of DM among the TB patients

59% while the NNS to detect a new case of DM was 18. The
prevalence of DM among patients who were older than 40 years was far higher
than among younger persons; sex on the other hand was not associated with the occurrence
of DM. The additional yield of DM was greater among older patients, persons who
sought care at a public facility, rural residents and HIV-negative persons. In
all, factors favouring occurrence of DM among TB patients in the study group
were older age (over 40 years), private facility care and rural residence.
Conversely, patients engaged in occupations with vigorous activity were less
likely have DM.  

In this study we found a high prevalence of DM among the TB
patients (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 to
age <50, female gander, non smokers, BMI range <25, type I treatment category and extra pulmonary tuberculosis. In present study the prevalence of diabetes among tuberculosis patients was 11.9% and that of pre diabetes was 15.3 %. Similar results were reported in earlier studies by Singla et al.,10 Raghuraman et al.,11 Khanna et al.,12 A.Kumar et al 2013 13 and Balakrishnan et al. 14Zhang Q et al. 2009,15 with 25%, 29%, 14.5%,13% and 44% 9.5%, prevalence of diabetes among TB patients. This study found a significantly higher prevalence of DM in older TB patients (age>50). Similar finding have been reported by studies from other parts of
India and others contries16171819. This
study also reported the higher association of DM and PTB, which is also
reported in many studies including those by Zhang et al.15 and Guptan and
Shah18. This study
has reported significantly higher prevalence of DM among male gender, which is
supported by that reported in the study conducted in south India 20.

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Result of the current study
shows that diabetes among alcoholic tuberculosis patients to be more as compare
to non alcoholic patients, and the difference was not significant. Similar
result seen earlier study 21 11
shows that Alcohol consumption was found to be a risk factor for diabetes in TB
patients.

The present study shows that diabetes
was more common among TB patients with BMI more 25 (19.0%) as compare to those
with 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 tuberculosis was significantly more among type II category tuberculosis patients as compare to Type I treatment category tuberculosis.  Finding of this study was supported by earlier study 22,23. In current study we found that smoker tuberculosis patients have significantly more diabetes (16.3%) as compared to non smoker tuberculosis patients (9.8%) (p=0.0001). Similar result was found in earlier study 24,25. The NNS to detect a new case of DM among TB patients was 22.  This number varies in from lower to among study from south India may we due to higher prevalence of diabetes mellitus. we found that NNS needed to detect one case of DM among TB patients decreases as the age increases14,26. This shows the importance of early screening of patients with TB and will enable us to manage these patients in the early phase. Pre-diabetes diagnose at early phase so that primary prevention methods may be initiated timely. As we higher burden of both TB and DM in our country, We need better information, recording and monitoring system to guide us in managing this co-morbidity, and we need to strengthen the care of these patients in our existing health services. Our study had several strengths. The strength of this study is that we implement this screening programme in routine programme settings. We also emphasis on the NNNS to diagnose a new case of DM with respect to different variables so we can focus on the lower value of NNS for screening on large scale. There were a few limitations like previous documentation of blood sugar not cross check. Mean time for sugar testing and disease duration was not same for each tuberculosis patients.