Title: Clinical Response and Treatment Response in Sputum Positive Diabetic and Non-Diabetic Patients
Authors: Dr Padmanabhan.K.V, Dr Muhammad Shafeek, Dr Jesinkumar .C, Dr Jerin Varghese, Dr Shinil.V, Dr Manoj.D.K
Tuberculosis is still a major public health problem in the world with an estimated 9.6 million new cases being diagnosed each year.. DM may delay sputum conversion and may increase the case fatality rate during treatment. Aim of our study was to find out the clinical pattern, radiological pattern and response to treatment of pulmonary tuberculosis among patients with and without diabetes mellitus:
Materials and Methods: 150 diabetics and non-diabetics with sputum positive pulmonary tuberculosis were selected, as cases and controls respectively. Data regarding the socio-demographic profile, age, sex, clinical presentation and radiological pattern were collected. Sputum smear examination was done in all patient at diagnosis, end of IP and end of treatment. Treatment was considered to have failed if the patient is positive at the end of 5 months treatment.
Results: There was no significant difference in the symptomatology and symptom score between diabetics (2.77) and non-diabetics (2.14). A higher percentage of diabetics (18.8%) showed lower zone involvement when compared to non-diabetics (5.8%). 19.3% of the diabetics were sputum positive at the end of IP of which 4.4% were sputum positive at the end of 5 months and had to undergo a change in treatment regimen due to failure.
Conclusion: Tuberculosis and diabetes frequently coexist in our population. The presence of diabetes may not significantly influence the symptomatology of the patients. However, DM has a negative effect on TB treatment with a larger number of diabetics requiring a change in category of ATT.
Keywords: Pulmonary Tuberculosis, Diabetes Mellitus, Sputum Conversion.