Diabetes screening among active tuberculosis patients in Western Australia Tuberculosis Control Program using HbA1c

Intern Med J. 2019 May;49(5):630-633. doi: 10.1111/imj.14143.

Abstract

Background: Diabetes mellitus is an important risk factor for tuberculosis (TB), and studies in high TB burden countries have shown diabetes screening to be both feasible and to have a high yield. However, scarce information is available for low TB burden countries. Diabetes screening was previously not part of our routine practice.

Aim: To screen and determine the prevalence of diabetes in the Western Australian Tuberculosis Control Program.

Methods: We measured HbA1c and random plasma glucose in patients with active TB. We also collected details on their demographics, TB and diabetes.

Results: A total of 105 patients was recruited over a year. Of those, 17 (16.2%) had diabetes. Seven cases (6.7%) were newly diagnosed diabetics. Age, cavitating disease and family history of diabetes were found to be significantly associated with diabetes. Multilobar disease, gender, body mass index, smear and culture positivity were not significantly different between groups.

Conclusion: Our study showed high prevalence of diabetes among active TB patients. Diabetes screening at diagnosis of active TB presents as a good opportunity to detect diabetes even in low prevalence country and has become part of our standard care.

Keywords: TB control; diabetes screening; tuberculosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology*
  • Female
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Infection Control / methods
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Tuberculosis / blood*
  • Tuberculosis / diagnosis
  • Tuberculosis / epidemiology*
  • Western Australia / epidemiology
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human