High prevalence and heterogeneity of Dysglycemia in patients with tuberculosis from Peru: a prospective cohort study

Background:

Diabetes mellitus (DM) triples the risk of developing active tuberculosis (TB), and prediabetes (preDM) has also emerged as a relevant risk factor. Despite international and national recommendations for screening, many individuals remain unaware of their glycemic status. The accuracy of different laboratory tests in TB-affected populations is poorly understood, often leading to under-notification of the comorbid TB-DM burden.

Abstract:

Methods: A prospective cohort study was conducted in Lima, Peru, involving 136 TB patients and 138 household contacts (HHC). Fasting plasma glucose (FPG), HbA1c, and oral glucose tolerance tests (OGTT) were used to detect DM and preDM.

Results: Prevalence of DM and preDM in TB patients was 13.97% and 30.88%, respectively, while lower rates were found in contacts (DM: 6.52%; preDM: 28.99%). FPG, HbA1c, and OGTT showed poor agreement in detecting preDM. Notably, TB-DM patients exhibited substantially lower hemoglobin levels, which significantly reduced the accuracy of HbA1c-based diagnosis.

Conclusion: Lima faces a high prevalence of dysglycemia among TB patients and their contacts. Anemia is a critical confounder for HbA1c testing in this population. Routine screening using multiple diagnostic methods (FPG and OGTT in addition to HbA1c) is necessary for early detection and improved clinical outcomes.

Keywords: Diabetes mellitus, Prediabetes, Tuberculosis, Comorbidity, Prevalence.

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• Data de Publicação: 11/09/2019
• Autores: Roger I. Calderon1,2*† , Maria B. Arriaga3,4,5,6† , Kattya Lopez1 , Nadia N. Barreda1 , Oswaldo M. Sanabria1 , José F. Fróes Neto6,7, Davi Neri Araújo3,6, Leonid Lecca1,8 and Bruno B. Andrade3,4,5,6,7,9,10*