title: High prevalence of undiagnosed diabetes among tuberculosis patients in peripheral health facilities in Kerala.
abstract: METHODS
  Two tertiary care hospitals and 12 peripheral health institutions (PHIs) in Trivandrum, Kerala, India.
  
  
  OBJECTIVE
  To determine factors associated with the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients and examine differences in the proportion of new DM cases among TB patients diagnosed at tertiary care centres and PHIs.
  
  
  METHODS
  A descriptive study: TB patients diagnosed during March-September 2012 were screened for known DM. Those with unknown DM status were tested for random blood glucose and fasting blood glucose (FBG); FBG ≥ 126 mg/dl was diagnosed as new DM.
  
  
  RESULTS
  Of 920 TB patients, 689 (72%) were male and the mean (standard deviation) age was 47.6 (16.4) years. Of these, 298 (32.4%) were diabetic: 235 (26%) had previously known DM and 63 (7%) were newly diagnosed. During the screening at PHIs and tertiary care hospitals, respectively 30/183 (16.4%) and 33/737 (4.5%) were newly diagnosed with DM (OR 3.71; 95%CI 2.17-6.32). Overall, age >50 years and pulmonary tuberculosis were independently associated with a higher prevalence of diabetes.
  
  
  CONCLUSIONS
  As nearly one in three TB patients had DM, we recommend that TB patients should be routinely screened for DM in Kerala. As the proportion of new DM was higher among TB patients diagnosed at PHIs, we would recommend that specific attention and investment be directed to PHIs.
authors.affiliation: Department of Pulmonary Medicine, Medical College, Trivandrum, Thiruvananthapuram, India.
authors.forename: S
authors.initials: S
authors.lastname: Nair
authors.affiliation: Department of Pulmonary Medicine, Medical College, Trivandrum, Thiruvananthapuram, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Kumari
authors.affiliation: Directorate of Health Services, Thiruvananthapuram, Kerala, India.
authors.forename: J
authors.initials: J
authors.lastname: Subramonianpillai
authors.affiliation: Directorate of Health Services, Thiruvananthapuram, Kerala, India.
authors.forename: D S
authors.initials: DS
authors.lastname: Shabna
authors.affiliation: Directorate of Health Services, Thiruvananthapuram, Kerala, India.
authors.forename: S M
authors.initials: SM
authors.lastname: Kumar
authors.affiliation: World Health Organization Country Office in India, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Balakrishnan
authors.affiliation: World Health Organization Country Office in India, New Delhi, India.
authors.forename: B
authors.initials: B
authors.lastname: Naik
authors.affiliation: International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India.
authors.forename: A M V
authors.initials: AM
authors.lastname: Kumar
authors.affiliation: Médecins Sans Frontières, Operational Research Unit, Luxembourg.
authors.forename: P
authors.initials: P
authors.lastname: Isaakidis
authors.affiliation: International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Satyanarayana
keywords: DM; Kerala; RNTCP; TB; screening