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Category: Volume 05 Issue 09 September 2017
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Title: Effect of Glycemic Control on Radiographic Presntation of Pulmonary Tuberculosis in Type 2 Diabetes Mellitus

Author: Dr Bhanu Rekha Bokam, M D

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i9.17

Abstract

Introduction: Tuberculosis (TB) remains to be a major cause of morbidity and mortality throughout the world. The link of Diabetes (DM) and TB is more prominent in developing countries and the higher susceptibility of tuberculosis in diabetics may be related to a longer duration of disease or due to poor glycemic control.

Aims: To study the effect of glycemic control on radiographic presentation of pulmonary Tuberculosis in Diabetics.

Methodology: It”s a prospective cross sectional study. Patients above 18 years, having Pulmonary Tuberculosis with Diabetis Mellitus were included.

Pulmonary Tuberculosis with other immunocompromised conditions like HIV, Chronic kidney disease, Malignancy, Long term steroids, Immunosuppressive drugs were excluded.

Glycemic control was assessed by glycated haemoglobin (HbA1C)<7 as controlled >7 as uncontrolled. Demographic, Clinical and Radiographic parameters were studied in respect to their glycemic control.

Results: There were 200 tuberculosis patients, 88 were diabetic, with 44%prevalence. The mean age was 52.13+10.93; 52%were males, mean HbA1C was 9.04±1.70; 93.2%had uncontrolled glycemic status.78(59.0%) had lower lung field abnormalities;mean HbA1C 8.87, 39(29.5%)had upper lung field; HbA1C 9.25 and 11.3%both lung fields; HbA1C 9.36. 108(81.8%)had nodular infiltrative lesions, 18(13.6%)had cavities; HbA1C 9.88. 83.3%had cavities in lower lung fields.

Conclusion: Prevalence of Diabetes among Pulmonary Tuberculosis is in the rise with uncontrolled diabetic patients predominantly affected. Lower lung field involvement with atypical radiographic presentations are more common in patients with diabetes. Patients with poor glycaemic control demonstrated cavitary lesions more than their counterparts but has no significant effect on zonal distribution of the radiographic lesion.

Key Words: Pulmonary Tuberculosis, Diabetes Mellitus, Glycemic control, Glycated Haemoglobin, HbA1C,

 

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Corresponding Author

Dr Bhanu Rekha Bokam, M D

Professor, Department of Pulmonary Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences &Research Foundation, Chinoutpalli, Vijayawada, Krishna Dt., Andhra Pradesh, India

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