Clinicoradiological profile of Diabetes Mellitus with MDR-TB

Abstract

Background: Studies have established the bidirectional link between diabetes and TB. It is hypothesized that diabetes worsens the clinical course of TB treatment. Furthermore, in TB, the glycemic control in diabetics is impaired. A plausible hypothesis of TB correlation is the impaired host defense in individuals in diabetics. Currently, there is limited research work on diabetes mellitus (DM) in TB patients; none in the study area. Also there are very limited studies depicting the clinico-radiological profile of DM in MDR TB. In this backdrop, the current study was conducted with an objective to establish a correlation with the severity of diabetes (HbA1C) with the clinical and radiological finding (Chest X-ray).Methodology-A Retrospective cross-sectional study of267 MDR TB cases enrolled in GANDHI MEDICAL COLLEGE BHOPAL from November 2019 to November2020. Patients with Known case of DM &DRTB with atleast rifampicin resistant were included. Self-reported information on age, sex, address, symptoms at presentation and treatment history of TB(Old & New) &DM was collected by trained investigators. Chest x ray was then evaluated & correlated by trained professionals on different parameters. Results- Among 267 patients 12.7 % of cases are DM-MDR TB Coinfected .Maximum cases was found among 40-60 year age group with male predominance. Severity of symptoms & maximum radiological involvement was found in severe uncontrolled diabetes. Also DM-MDR TB Coinfection more common among patients with history of TB as compared to patients with no history of TB. According to study results Significant p value was found in radiological & symptomatic correlation with HbA1c in MDR TB patients but P value was not significant in patients with old h/o TB.Conclusion- Early detection can help improve care and treatment outcomes of both diseases. All people with TB should be systematically screened for diabetes. Patients with old h/o TB are at increased risk of reactivation, reinfection. Xray & and timely detections of symptoms could be used as an important screening tool.