Diabetes mellitus among tuberculosis patients: a cross sectional study from Pakistan.

Zarfishan Tahir, Mansur-ud-Din Ahmad, Abdul Majeed Akhtar, Tahir Yaqub, Muhammad Hassan Mushtaq2, Hasnain Javed
1. Department of Bacteriology, Institute of Public Health, Lahore, Punjab, Pakistan.
2. University of Veterinary and Animal Sciences, Lahore, Punjab , Pakistan.
3. Provincial TB Control Program, Punjab, Pakistan.
4. Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan.

Abstract
Background:The co-occurrence of diabetes mellitus (DM) and tuberculosis (TB) is largely associated with high frequency of  morbidity.

Objective: To determine the prevalence of DM among TB patients and describe the socio-demographic and behavioral factors  associated with TB-DM co-occurrence .

Methods: We enrolled 500 TB patients from September, 2014 to August 2015 at four major public sector hospitals of Lahore,  Pakistan. A questionnaire was used to collect information regarding associated socio-demographic and behavioral factors of the  patients. We monitored the fasting blood sugar of each patient by using a semi automated clinical chemistry analyzer followed  by an HbA1c level check of all hyperglycemic patients.

Results: The prevalence of TB-DM co-occurrence was 14.8%. The prevalence of TB-DM was higher (62.2%) among males.  The >57 year age group had the highest proportion of patients (35.1%), with co-existent TB-DM. Most were illiterate (73.0%)  and unemployed (48%). Moreover, among the 74 patients positive for TB-DM had a history of smoking. Age and education  level were significantly associated with DM-TB while gender, occupation and smoking were not associated.

Conclusion: The study revealed a 14.8% prevalence of DM among TB patients. This was associated with several socio-demographic factors, including age, unemployment, literacy and polluted environment. Thus, poor and unhealthy lifestyles were the  factors associated with DM among immunologically compromised individuals due to TB.

Keywords: Tuberculosis (TB), diabetes mellitus (DM), socio-demographic and behavioral factors.