Glucose intolerance

among newly detected

cases of
Tuberculosis
Dr Pallabi Dash, Prof Dr Jayanta Kumar Panda, Assoc Prof Dr M R Dash

Presented By: Dr Pallabi Dash

PG Resident
SCBMCH
Tuberculosis Diabetes

10 million cases 537 million cases

1.6 million deaths 1 6.7 million deaths 2

TB DM
Co epidemic
1.5 million TB DM
WHO recommends
bidirectional screening
Diabetes : Risk Factor for TB 3

Twofold to threefold risk of

TB disease
Twofold risk of death during
TB treatment
Fourfold risk of TB relapse
after treatment completion
Twofold risk of multidrug-
resistant TB (MDR-TB)
 Tuberculosis: Risk Factor For
Glucose Intolerance And Diabetes
1. Transient stress hyperglycemia 4
 2. Pancreatic islet amyloid
deposits 5

3. Direct invasion of pancrease by

mycobacteria 5
· To assess the glycemic status of the recruited patients during
the treatment period of tuberculosis
· To estimate the prevalence of glucose intolerance (prediabetes,
diabetes and transient hyperglycaemia) in newly detected cases
of tuberculosis
· Study type: Prospective Longitudinal Study
· Time period of Study: July 2021 – July 2022
· Place of Study: PG Department of Medicine and PG
Department of Pulmonary Medicine, S.C.B Medical College &
Hospital, Cuttack.
· Sample size: 100 patients
· Sampling technique: Convenient Sampling
Inclusion criteria:
bacteriologically confirmed cases
of tuberculosis with
o Age: >18 years
o Sex : both male and female
o Type of infection: both
pulmonary and extra pulmonary
infections
· Exclusion criteria:
o Diagnosed cases of diabetes developing TB
o Patients with serious life threatening tuberculosis infection
o Pregnant women
o Patients on drugs causing hyperglycaemia: steroids, beta
blockers, thiazide diuretics, atypical antipsychotics,
levofloxacin
o HIV positive patients
o Patients with (BMI ≥30 kg/ m2) or increased waist
circumference measurement (males >102 cm; females >88 cm)
Methodology:

Microscopy CBNAAT
 Overnight fasting

Fasting plasma glucose test

75g oral glucose load

Post glucose plasma glucose test

 75g Oral Glucose
tolerance test

At recruitment At end of At end of

intensive phase continuation
phase
Baselin characteristics Mean +/- SD
Age 44+/-10 years
Sex Male= 58%, female = 42%
Height 158+/- 7 cm
Weight 54+/- 6 kg
BMI 20+/- 2 Kg/m2

Educational qualificaltion Less than graduate = 69%

Graduate = 31%
History of TB Posiive = 22% Negetive = 78%
Contact with TB Positive = 12% Negetive = 88%
Type of TB infection
Distribution of Glucose Status at recruitment
5. Type of TB infection among patients with glucose intolerance
6. Correlation of Sputum positivity with HbA1c
7. Distribution of Glucose Status At End Of Continuation
Phase
Further follow up required

Smaller sample size

Single centre study

Remember
Recall
Reassess
 References
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Diagnosed Tuberculosis Patients in Tribal Odisha: An Exploratory Study. J Clin Diagn Res.
2016 Oct;10(10):LC06-LC08. doi: 10.7860/JCDR/2016/20999.8704. Epub 2016 Oct 1.
PMID: 27891359; PMCID: PMC5121697
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journal of ophthalmology, 69(11), 2932–2938. https://doi.org/10.4103/ijo.IJO_1627_21
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35321845; PMCID: PMC8934249.
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Tuberculosis Disease: Epidemiology and Clinical Implications. Curr Diab Rep 18, 71
(2018). https://doi.org/10.1007/s11892-018-1036-y
5. Broxmeyer L. Diabetes mellitus, tuberculosis and the mycobacteria: two millenia of
enigma. Med Hypotheses. 2005;65(3):433-9. doi: 10.1016/j.mehy.2005.04.017. PMID:
15967589.