Diabetes and Tuberculosis – Tackling Double Trouble

Introduction: Diabetes mellitus (DM) is an important and recognized risk factor for tuberculosis (TB). India is a high TB burden country along with an increased prevalence of diabetes in its population. The current study aimed to study the diagnostic profile and treatment outcomes of tuberculosis in diabetics (TBDM) as compared to that in non-diabetics. Materials and methods: A retrospective analysis from clinical records of TB patients diagnosed between November 2016 to April 2018 (eighteen months) was carried out in a tertiary care teaching institute. Results : Out of a total 1592 TB patients diagnosed during the study period, 66 (4.15 %) patients were diabetics. Amongst them, 49 patients had declared outcomes and were analyzed further. 98 TB patients without diabetes, diagnosed during the same period, were selected randomly in 1:2 ratio as the control group. There were 26(53%) microbiologically confirmed TB patients and 23(47%) clinically diagnosed TB cases among diabetics as compared to 43(43.87%) microbiologically confirmed TB patients and 55(56.12%) clinically diagnosed TB cases among non-diabetics. There were 41(83.63%) pulmonary and 8(16.32%) extra- pulmonary TB cases among diabetics as compared to 56 (57.14%) pulmonary and 41(42.85%) extra-pulmonary TB cases among non-diabetics. Among diabetics, 39 (79.59%) patients were newly diagnosed and 10(20.40%) patients were retreatment cases of TB whereas 80(81.63 %) patients were newly diagnosed and 18(18.36 %) patients were retreatment cases of TB among non- diabetics. Poor treatment outcome of TB was seen in 14 (28.57%) diabetics as compared to 10(10.2%) non-diabetics. Discussion: Diabetics are at an increased risk of developing pulmonary TB. TB is associated with poor treatment outcome in diabetics. Conclusion: A robust screening of diabetics for TB is imperative and the healthcare provider must be well aware of the diagnostic spectrum and possible poor treatment outcomes of TB in these patients.