title: Prevalence of diabetes and pre-diabetes and associated risk factors among tuberculosis patients in India.
abstract: BACKGROUND
  Diabetes mellitus (DM) is recognised as an important risk factor to tuberculosis (TB). India has high TB burden, along with rising DM prevalence. There are inadequate data on prevalence of DM and pre-diabetes among TB cases in India. Aim was to determine diabetes prevalence among a cohort of TB cases registered under Revised National Tuberculosis Control Program in selected TB units in Tamil Nadu, India, and assess pattern of diabetes management amongst known cases.
  
  
  METHODS
  827 among the eligible patients (n = 904) underwent HbA1c and anthropometric measurements. OGTT was done for patients without previous history of DM and diagnosis was based on WHO criteria. Details of current treatment regimen of TB and DM and DM complications, if any, were recorded. A pretested questionnaire was used to collect information on sociodemographics, habitual risk factors, and type of TB.
  
  
  RESULTS
  DM prevalence was 25.3% (95% CI 22.6-28.5) and that of pre-diabetes 24.5% (95% CI 20.4-27.6). Risk factors associated with DM among TB patients were age (31-35, 36-40, 41-45, 46-50, >50 years vs <30 years) [OR (95% CI) 6.75 (2.36-19.3); 10.46 (3.95-27.7); 18.63 (6.58-52.7); 11.05 (4.31-28.4); 24.7 (9.73-62.7) (p<0.001)], positive family history of DM [3.08 (1.73-5.5) (p<0.001)], sedentary occupation [1.69 (1.10-2.59) (p = 0.016)], and BMI (18.5-22.9, 23-24.9 and ≥25 kg/m(2) vs <18.5 kg/m(2)) [2.03 (1.32-3.12) (p = 0.001); 0.87 (0.31-2.43) (p = 0.78); 1.44 (0.54-3.8) (p = 0.47)]; for pre-diabetes, risk factors were age (36-40, 41-45, 46-50, >50 years vs <30 years) [2.24 (1.1-4.55) (p = 0.026); 6.96 (3.3-14.7); 3.44 (1.83-6.48); 4.3 (2.25-8.2) (p<0.001)], waist circumference [<90 vs. ≥90 cm (men), <80 vs. ≥80 cm (women)] [3.05 (1.35-6.9) (p = 0.007)], smoking [1.92 (1.12-3.28) (p = 0.017)] and monthly income (5000-10,000 INR vs <5000 INR) [0.59 (0.37-0.94) (p = 0.026)]. DM risk was higher among pulmonary TB [3.06 (1.69-5.52) (p<0.001)], especially sputum positive, than non-pulmonary TB.
  
  
  CONCLUSIONS
  Nearly 50% of TB patients had either diabetes or pre-diabetes.
authors: Diabetology, M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre, Chennai, Tamil Nadu, India. drvijay@mvdiabetes.com
authors: Vijay
authors: V
authors: Viswanathan
authors: Satyavani
authors: S
authors: Kumpatla
authors: Vigneswari
authors: V
authors: Aravindalochanan
authors: Rajeswari
authors: R
authors: Rajan
authors: C
authors: C
authors: Chinnasamy
authors: Rajan
authors: R
authors: Srinivasan
authors: Jerard Maria
authors: JM
authors: Selvam
authors: Anil
authors: A
authors: Kapur
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology*