TUBERCULOUS PATIENTS

DIAGNOSTIC SIGNIFICANCE OF FASTING BLOOD GLUCOSE (AFB)

Abstract

The objective of present study was to screen out the diabetes mellitus by fasting
blood glucose (FBG) in patients with pulmonary tuberculosis. Background: Diabetes mellitus
and Tuberculosis has strong co-relation and complicates each other. Diabetes increases the
risk of infections including tuberculosis particularly pulmonary TB, Therefore making antituberculous
drugs ineffective. Similarly M. tuberculous infection predisposes to diabetes
mellitus and complicates it further. Patients simultaneously having, both diabetes mellitus and
tuberculosis, the chances of multiple systems involvement becomes high. The delayed or
ineffective response to anti tuberculous chemotherapy raises suspicion of underlying diabetes
mellitus .There for such patients should be screen out by fasting blood glucose (FBG) levels so
as to treat the treat the diabetes as well. Objectives: The objective of this study was to screen
out diabetes in pulmonary TB patients by fasting blood glucose level (FBG) especially where
the treatment response of anti-tuberculous drug is delayed or poor. Study Design: This was
prospective observational study. Place and Duration of Study: This study was conducted
at DHQ-teaching hospital Mirpur Azad Kashmir from February 2013 to December 2014 .This
included both in and outdoor patients. Inclusion criteria: 1. Age range of tuberculous patients
between 20-40 years. 2. Pulmonary tuberculous patients. Exclusion criteria: 1. Pulmonary
TB patients with co-existent diabetes mellitus. 2. TB patients with renal failure, autoimmune
diseases like rheumatoid arthritis, SLE, immunosuppressant drugs and steroid were excluded.
Material and Methods: Ninety-five diagnosed patients of pulmonary TB were selected. The
questionnaire form was designed according to objective of study. This Included with patients
having pulmonary TB with but still not screened out for diabetes .The questionnaire contained
history, general physical and systemic examination, especially respiratory system. Risk factors
like family history of diabetes and TB were evaluated. The socio–economic status of patients was
carefully assessed. Routine investigations like complete blood count, ESR, fasting and random
blood glucose were done. Three morning sputum specimens and fasting blood glucose (FBG)
were main tools of diagnosis of TB. The data thus obtained, was subjected to SPSS verssion-20
for statistical analysis. Results: A total of 95 patients with pulmonary tuberculosis were selected
including in and outdoor patients. Out of them, 65 patients were males, and 30 were females.
Age group mainly ranging between 20-40 of years. Screening of diabetes in 95 tuberculous
patients was done by fasting blood glucose. Seventeen patients (17), twelve (12) male and five
(05) female were screened out to be diabetic. Conclusion: Screening by fasting blood glucose
is an effective tool in diagnosis of diabetes mellitus in tuberculous patients.