Quantum of Stress Hyperglycemia at the Time of Initial Diagnosis of Tuberculosis

Background India has a high burden of both tuberculosis (TB) and diabetes mellitus (DM). The National TB Elimination Program recommends testing for glycemic status at the initiation of therapy; however, some individuals with elevated sugar levels might have stress hyperglycemia (SH) instead of true...

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Published inCurēus (Palo Alto, CA) Vol. 15; no. 3; p. e36382
Main Authors Tarachandani, Divya, Singhal, Kritika, Goyal, Abhishek, Joshi, Ankur, Joshi, Rajnish
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 20.03.2023
Cureus
Subjects
Clinical outcomes
Diabetes
Drug therapy
Endocrinology/Diabetes/Metabolism
Fasting
Glucose
Hyperglycemia
Infections
Internal Medicine
Medical diagnosis
Plasma
Pulmonology
Tuberculosis
India
stress hyperglycemia
active pulmonary tuberculosis
tuberculosis(tb)
diabetes mellitus type 2
glycosylated hemoglobin (hba1c)
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Summary:Background India has a high burden of both tuberculosis (TB) and diabetes mellitus (DM). The National TB Elimination Program recommends testing for glycemic status at the initiation of therapy; however, some individuals with elevated sugar levels might have stress hyperglycemia (SH) instead of true DM. Our aim was to perform a longitudinal glycemic assessment of individuals with TB to identify those with true newly diagnosed DM and those with SH. Methods We identified newly diagnosed adults with TB and abstracted information about demography, co-morbidities, disease severity, and glucose-lowering agents. A glycemic assessment was performed at baseline and at the end of six months. Results We included 150 patients with TB, and based on their initial HbA1c values, 82 (54.6%, 95% CI: 46-62%) had dysglycemia (30% had HbA1c levels above 6.4% and 24.6% had values between 5.9% and 6.4%) and 31 (20.7%, 95% CI: 14-18%) had SH. Among individuals with both baseline and follow-up glycemic values, 30% of the individuals previously defined as DM were characterized as SH. The proportion of true SH was 43% (95% CI: 33-60%). Conclusion Most individuals who have dysglycemia at the time of their TB diagnosis have SH. A close follow-up of such individuals will identify those who really require long-term glucose-lowering therapy.
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ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.36382