Volume 14, Issue 4 (Autumn 2025)                   J Occup Health Epidemiol 2025, 14(4): 248-255 | Back to browse issues page

Ethics code: 8714/IEC/2023

XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Selvan P, Nagesh N J, Leela K V. Tuberculosis and Type 2 Diabetes Mellitus Comorbidity in a South Indian Population: An Emerging Dual Burden. J Occup Health Epidemiol 2025; 14 (4) :248-255
URL: http://johe.rums.ac.ir/article-1-1103-en.html

Related article in
Google Scholar

1- Ph.D. in Medical Microbiology, Dept. of Microbiology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur – 603203, Chengalpattu District, Tamilnadu, India. , jeevepavi123@gmail.com
2- Professor and Head, Dept. of Respiratory Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur – 603203, Chengalpattu District, Tamilnadu, India.
3- Professor and Head, Dept. of Microbiology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur – 603203, Chengalpattu District, Tamilnadu, India.
Article history
Received: 2025/08/17
Accepted: 2025/10/18
ePublished: 2025/12/13
Subject: Epidemiology
Abstract:   (27 Views)
Background: Diabetes mellitus (DM) and tuberculosis (TB) significantly contribute to morbidity and mortality in India, and routine DM screening in TB patients is recommended. This study aimed to determine the prevalence of DM among newly diagnosed pulmonary TB (PTB) patients and identify associated risk factors at a tertiary care center in South India.
Materials and Methods: A retrospective cross-sectional study was conducted in India, from January to December 2023, using hospital and laboratory records. Adults aged 18–75 years with newly diagnosed pulmonary tuberculosis (PTB), with or without type 2 diabetes mellitus (T2DM), were included.  PTB was diagnosed based on microbiological, radiological, and clinical criteria. Key demographic, behavioral, and clinical data were collected. Glycemic status was assessed using HbA1c levels. Data were analyzed using SPSS version 23, applying the chi-square test and logistic regression.
Results: In this study, 117 (3.7%) of the 3,127 suspected PTB cases received a new diagnosis; the majority of these patients were male (71.7%), and the median age (Interquartile Range) was 56 (38.7-62) years. Glycated hemoglobin (HbA1c) assessment revealed that 52 (44.5%) had normoglycemia, 4 (3.4%) were prediabetic, and 61 (52.1%) had Type 2 Diabetes Mellitus (T2DM). Notably, among PTB patients with DM, the majority of them had HbA1c levels ≥ 6.5% (93.8%; n=61), with a higher prevalence in males (72.4%) than in females (21.5%). 
Conclusion: Timely and regular DM screening in TB patients, particularly at diagnosis, is essential to reduce the dual burden of TB–DM comorbidity.
Full-Text [PDF 340 kb]   (14 Downloads)    

References
1. Alturki S, Al Amad M, Mahyoub E, Al Hanash N, Alhammadi A. Prevalence of Diabetes Mellitus among Patients with Tuberculosis and Its Associated Factors in Sana'a, Yemen, 2021. Epidemiologia (Basel, Switzerland). 2023;4(2):202-11. [DOI] [PMID] [PMCID]
2. World Health Organization. Tuberculosis. Geneva, Switzerland: World Health Organization; 2024.
3. World Health Organization. Global Tuberculosis Report 2023. Geneva, Switzerland: World Health Organization; 2023.
4. Foe-Essomba JR, Kenmoe S, Tchatchouang S, Ebogo-Belobo JT, Mbaga DS, Kengne-Ndé C, et al. Diabetes mellitus and tuberculosis, a systematic review and meta-analysis with sensitivity analysis for studies comparable for confounders. PLoS One. 2021;16(12):e0261246. [DOI] [PMID] [PMCID]
5. Gautam S, Shrestha N, Mahato S, Nguyen TPA, Mishra SR, Berg-Beckhoff G. Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: a systematic review and meta-analysis. Sci Rep. 2021;11(1):2113. [DOI] [PMID] [PMCID]
6. Ekeke N, Ukwaja KN, Chukwu JN, et al. Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings. Sci Rep. 2017;7:44205. [DOI] [PMID] [PMCID]
7. Araia ZZ, Mesfin AB, Mebrahtu AH, Tewelde AG, Osman R, Tuumzghi HA. Diabetes Mellitus and Its Associated Factors in Tuberculosis Patients in Maekel Region, Eritrea: Analytical Cross-Sectional Study. Diabetes Metab Syndr Obes. 2021;14:515-23. [DOI] [PMID] [PMCID]
8. Silva DR, Muñoz-Torrico M, Duarte R, Galvão T, Bonini EH, Arbex FF, et al. Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs. J Bras Pneumol. 2018;44(2):145-52. [DOI] [PMID] [PMCID]
9. Lin Y, Harries A D, Kumar A M V, Critchley J A, van Crevel R, Owiti P, et al. Management of Diabetes Mellitus-Tuberculosis: A Guide to the Essential Practice. 1st ed. Paris, France: International :union: Against Tuberculosis and Lung Disease; 2019. [Report]
10. Lesnic E, Malic A, Tafuni O. The impact of diabetes mellitus on the anti-tuberculosis treatment outcome: a series of cases from the Republic of Moldova. Med Pharm Rep. 2021;94(3):325-32. [DOI] [PMID] [PMCID]
11. Wang Q, Ma A, Han X, Zhao S, Cai J, Ma Y, et al. Prevalence of type 2 diabetes among newly detected pulmonary tuberculosis patients in China: a community based cohort study. PLoS One. 2013;8(12):e82660. [DOI] [PMID] [PMCID]
12. Viswanathan V, Kumpatla S, Aravindalochanan V, Rajan R, Chinnasamy C, Srinivasan R, et al. Prevalence of diabetes and pre-diabetes and associated risk factors among tuberculosis patients in India. PLoS One. 2012;7(7):e41367. [DOI] [PMID] [PMCID]
13. Shidam UG, Roy G, Sahu SK, Kumar SV, Ananthanarayanan PH. Screening for diabetes among presumptive tuberculosis patients at a tertiary care centre in Pondicherry, India. Int J Tuberc Lung Dis. 2015;19(10):1163-8. [DOI] [PMID]
14. Moreno-Martínez A, Casals M, Orcau À, Gorrindo P, Masdeu E, Caylà JA, et al. Factors associated with diabetes mellitus among adults with tuberculosis in a large European city, 2000-2013. Int J Tuberc Lung Dis. 2015;19(12):1507-12. [DOI] [PMID]
15. Raghuraman S, Vasudevan KP, Govindarajan S, Chinnakali P, Panigrahi KC. Prevalence of Diabetes Mellitus among Tuberculosis Patients in Urban Puducherry. N Am J Med Sci. 2014;6(1):30-4. [DOI] [PMID] [PMCID]
16. American Diabetes Association. Standards of Care in Diabetes—2023 Abridged for Primary Care Providers. Clin Diabetes. 2023;41(1):4-31. [DOI] [PMID] [PMCID]
17. Sharma P, Visnegarwala F, Tripathi V. Burgeoning double burden of tuberculosis and diabetes in India: Magnitude of the problem – strategies and solutions. Clin Epidemiol Glob Health. 2014;2(3):107-16. [DOI]
18. Boadu AA, Yeboah-Manu M, Osei-Wusu S, Yeboah-Manu D. Tuberculosis and diabetes mellitus: The complexity of the comorbid interactions. Int J Infect Dis. 2024;146:107140. [DOI] [PMID]
19. Ferlita S, Yegiazaryan A, Noori N, Lal G, Nguyen T, To K, et al. Type 2 Diabetes Mellitus and Altered Immune System Leading to Susceptibility to Pathogens, Especially Mycobacterium tuberculosis. J Clin Med. 2019;8(12):2219. [DOI] [PMID] [PMCID]
20. Shamseeda A, Jayasree AK. Epidemiological profile of extrapulmonary tuberculosis and its association with diabetes in Tertiary Care Center in Northern Kerala. Int J Community Med Public Health. 2022;9(6):2590-5. [DOI]
21. Rajaa S, Krishnamoorthy Y, Knudsen S, Roy G, Ellner J, Horsburgh CR, et al. Prevalence and factors associated with diabetes mellitus among tuberculosis patients in South India-a cross-sectional analytical study. BMJ Open. 2021;11(10):e050542. [DOI] [PMID] [PMCID]
22. Pande T, Huddart S, Xavier W, Kulavalli S, Chen T, Pai M, et al. Prevalence of diabetes mellitus amongst hospitalized tuberculosis patients at an Indian tertiary care center: A descriptive analysis. PLoS One. 2018;13(7):e0200838. [DOI] [PMID] [PMCID]
23. Aftab H, Ambreen A, Jamil M, Garred P, Petersen JH, Nielsen SD, et al. High prevalence of diabetes and anthropometric heterogeneity among tuberculosis patients in Pakistan. Trop Med Int Health. 2017;22(4):465-73. [DOI] [PMID]
24. Mi F, Jiang G, Du J, Li L, Yue W, Harries AD, et al. Is resistance to anti-tuberculosis drugs associated with type 2 diabetes mellitus? A register review in Beijing, China. Glob Health Action. 2014;7:24022. [DOI] [PMID] [PMCID]
25. Aftab H, Ambreen A, Jamil M, Garred P, Petersen JH, Nielsen SD, et al. High prevalence of diabetes and anthropometric heterogeneity among tuberculosis patients in Pakistan. Trop Med Int Health. 2017;22(4):465-73. [DOI] [PMID]
26. Mi F, Jiang G, Du J, Li L, Yue W, Harries AD, et al. Is resistance to anti-tuberculosis drugs associated with type 2 diabetes mellitus? A register review in Beijing, China. Glob Health Action. 2014;7:24022. [DOI] [PMID] [PMCID]
27. Workneh MH, Bjune GA, Yimer SA. Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review. PLoS One. 2017;12(4):e0175925. [DOI] [PMID] [PMCID]
28. Achanta S, Tekumalla RR, Jaju J, Purad C, Chepuri R, Samyukta R, et al. Screening tuberculosis patients for diabetes in a tribal area in South India. Public Health Action. 2013;3(Suppl 1):S43-7. [DOI] [PMID] [PMCID]
29. Thapa B, Paudel R, Thapa P, Shrestha A, Poudyal A, Poudyal AK. Prevalence of diabetes among tuberculosis patients and associated risk factors in Kathmandu Valley. SAARC J Tuberc Lung Dis HIV AIDS. 2015;12(2):20-7. [DOI:10.3126/saarctb.v12i2.15951]
30. Gadallah M, Amin W, Fawzy M, Mokhtar A, Mohsen A. Screening for diabetes among tuberculosis patients: a nationwide population-based study in Egypt. Afr Health Sci. 2018;18(4):884-90. [DOI] [PMID] [PMCID]
31. Huber FG, Kristensen KL, Holden IK, Andersen PH, Bakir B, Jørgensen A, et al. The prevalence of diabetes among tuberculosis patients in Denmark. BMC Infect Dis. 2022;22(1):64. [DOI] [PMID] [PMCID]
32. Alisjahbana B, Sahiratmadja E, Nelwan EJ, Purwa AM, Ahmad Y, Ottenhoff TH, et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis. 2007;45(4):428-35. [DOI] [PMID]
33. Pizzol D, Di Gennaro F, Chhaganlal KD, Fabrizio C, Monno L, Putoto G, et al. Tuberculosis and diabetes: current state and future perspectives. Trop Med Int Health. 2016;21(6):694-702. [DOI] [PMID]
34. Gill GV, Mbanya JC, Ramaiya KL, Tesfaye S. A sub-Saharan African perspective of diabetes. Diabetologia. 2009;52(1):8-16. [DOI] [PMID]
35. Hithaish Kumar RN, Rao CR, Maradi R, Umakanth S, Chidananda Sanju SV, Sreenivasa Rao BP. Impact of anemia on sputum smear conversion and treatment outcomes among newly diagnosed tuberculosis patients in Southern India. Int J Mycobacteriol. 2023;12(2):117-21. [DOI] [PMID]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
This work is licensed under a Creative Commons Attribution 4.0 International License.

2025 CC BY 4.0 | Journal of Occupational Health and Epidemiology

Designed & Developed by : Yektaweb