title: Overt diabetes mellitus among newly diagnosed Ugandan tuberculosis patients: a cross sectional study.
abstract: BACKGROUND
  There is a documented increase of diabetes mellitus in Sub Saharan Africa, a region where tuberculosis is highly endemic. Currently, diabetes mellitus is one of the recognised risk factors of tuberculosis. No study has reported the magnitude of diabetes mellitus among tuberculosis patients in Uganda, one of the countries with a high burden of tuberculosis.
  
  
  METHODS
  This was a cross-sectional study conducted among 260 consenting adult patients with a confirmed diagnosis of tuberculosis admitted on the pulmonology wards of Mulago national referral and teaching hospital in Kampala, Uganda to determine the prevalence of diabetes mellitus and associated clinical factors. Laboratory findings as well as the socio-demographic and clinical data collected using a validated questionnaire was obtained. Point of care random blood sugar (RBS) testing was performed on all the patients prior to initiation of anti tuberculosis treatment. Diabetes mellitus was diagnosed if the RBS level was ≥ 200mg/dl in the presence of the classical symptoms of diabetes mellitus.
  
  
  RESULTS
  The prevalence of diabetes mellitus among the admitted patients with tuberculosis was 8.5%. Only 5 (1.9%) patients with TB had a known diagnosis of diabetes mellitus at enrolment. Majority of the study participants with TB-DM co-infection had type 2 diabetes mellitus (n=20, 90.9%).At bivariate analysis, raised mean ALT concentrations of ≥80 U/L were associated with DM (OR-6.1, 95% CI 1.4-26.36, p=0.032) and paradoxically, HIV co-infection was protective of DM (OR-0.32, 95% CI 0.13-0.79, P=0.016). The relationship between DM and HIV as well as that with ALT remained statistically significant at multivariate analysis (HIV: OR- 0.17 95%CI 0.06-0.51, p=0.002 and ALT: OR-11.42 95%CI 2.15-60.59, p=0.004).
  
  
  CONCLUSIONS
  This study demonstrates that diabetes mellitus is common among hospitalized tuberculosis patients in Uganda. The significant clinical predictors associated with diabetes mellitus among tuberculosis patients were HIV co-infection and raised mean serum alanine transaminase concentrations.
authors.affiliation: Department of Medicine, St, Raphael of St, Francis hospital Nsambya, P.O. BOX 7146, Kampala, Uganda. davouirek@yahoo.co.uk
authors.forename: Davis
authors.initials: D
authors.lastname: Kibirige
authors.forename: Richard
authors.initials: R
authors.lastname: Ssekitoleko
authors.forename: Edrisa
authors.initials: E
authors.lastname: Mutebi
authors.forename: William
authors.initials: W
authors.lastname: Worodria
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000378:metabolism / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000097:blood / Q000453:epidemiology / Q000378:metabolism*; D014454:Uganda / Q000453:epidemiology
chemical_list: D001786:Blood Glucose