Abid Naeem.
Tuberculous patients; diagnostic significance of fasting blood glucose (AFB).
Professional Med J Jan ;23(01):045-9.

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.

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