Prevalence of diabetes mellitus amongst hospitalized tuberculosis patients at an Indian tertiary care center: A descriptive analysis

• Published in: PloS one 2018-07, Vol.13 (7), p.e0200838-e0200838
• Main Authors: Pande, Tripti, Huddart, Sophie, Xavier, Wilbin, Kulavalli, Srivathsa, Chen, Tanya, Pai, Madhukar, Saravu, Kavitha
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Analysis; Biology and Life Sciences; Body mass; Body Mass Index; Body size; Body weight; Care and treatment; Chronic diseases; Chronic illnesses; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Education; Epidemics; Epidemiology; Fasting; Female; Females; Glucose; Health aspects; Hemoglobin; Higher education; HIV; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Human immunodeficiency virus; Humans; Infectious diseases; Insulin; Laboratories; Male; Malnutrition; Medical diagnosis; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Multivariate Analysis; Nutrition; Nutritional status; Occupational health; Overweight; Pancreas; Patients; People and Places; Public health; Retrospective Studies; Sugar; Tertiary Care Centers - statistics & numerical data; Tuberculosis; Tuberculosis - epidemiology; Undernutrition; Underweight; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0200838

India has a high prevalence of tuberculosis (TB) as well as diabetes mellitus (DM). DM is a chronic disease caused by deficiency of insulin production by the pancreas. The risk of TB amongst DM patients is three times higher than those without. The estimated national prevalence of DM is 7.3%. Despite the growing burden of DM, there are limited studies describing the prevalence of TB-DM in India. Our study estimated the prevalence of DM amongst adult hospitalized TB patients at Kasturba Hospital, Manipal and determined factors associated with the likelihood of DM-TB co-prevalence. We conducted a retrospective cohort study at Kasturba Hospital, Manipal Academy of Higher Education. All hospitalized adult patients diagnosed with pulmonary TB (PTB) and extrapulmonary TB (EPTB) between June 1st 2015 and June 30th 2016 were eligible for inclusion. Pediatric and pregnant TB patients were excluded from our study. Data were extracted from medical charts. Descriptive and multivariate analyses were performed in R. Multivariate analysis adjusted for age, gender, type of TB, history of TB, and nutrition (body mass index (BMI)) status. A total of 728 patients met the eligibility criteria, 517 (71%) were male, 210 (29%) female, 406 (56%) had PTB and 322 (44%) had EPTB. Amongst those with a nutritional status, 36 (30%) patients were underweight (BMI 30.0 kg/m2). A total of 720 (98.9%) of TB patients had at least one blood sugar test result. The overall prevalence of DM (n = 184) amongst TB patients was 25.3% (95% CI 22.2%, 28.6%). When stratified, it was 35.0% (30.4%, 39.9%) and 13.0% (9.7%, 17.3%) amongst PTB and EPTB patients respectively. TB patients aged 41-60 years had 3.51 times higher odds (aOR 3.51 (2.08, 6.07)) of having DM than patients 40 years or younger. Patients aged 60 years or older had 2.49 times higher odds (aOR 2.49 (1.28, 4.85)) of having DM than younger patients (