Devanathan, V (2020) The Effect of Glycemic Control on Clinico-Radiological Presentations of Pulmonary Tuberculosis in Diabetes Mellitus Patients: A Cross Sectional study. Masters thesis, Stanley Medical College, Chennai.
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Abstract
BACKGROUND: Diabetes mellitus may increase the risk of Pulmonary Tuberculosis up to 3 times and influences its radiological manifestations. Radiological features of diabetic Tuberculosis patients shows increased frequency of atypical involvement. Diabetes being an immunosuppressive state, causes severe disease manifestations in Tuberculosis patients with more incidence of multi lobar, multi cavitary, and bilateral lung involvement. Hence early detection of diabetes and proper glycemic control helps to reduce the disease progression in Tuberculosis patients. OBJECTIVES: 1. To compare the clinico-radiological profile of Pulmonary Tuberculosis among Prediabetics, newly diagnosed diabetics and known diabetic patients. 2. To assess the clinico-radiological profile of Pulmonary Tuberculosis patients with good controlled and poorly controlled diabetes. STUDY PERIOD: From August 2018 to August 2019 for One year. STUDY CENTRE: Study was conducted in Government Hospital of Thoracic Medicine, Tambaram sanatorium, Tambaram and Department of Pulmonary Medicine, Government Stanley Medical College, Chennai. METHODOLOGY: 150 patients with newly detected microbiologically positive Pulmonary Tuberculosis who are willing to participate in this study were included. Based on the blood glucose and HbA1c levels patients were classified into prediabetics, newly diagnosed diabetics and known diabetic patients. HbA1C level of 7 was taken as a cut off to differentiate between good control and poorly controlled diabetes patients. The clinico-radiological features among the different groups are assessed. OBSERVATION: Cough was the predominant symptom seen in all the 3 groups ie prediabetes, newly diagnosed diabetes and known diabetes, followed by loss of appetite and fever. Prediabetes patients had a significantly lower frequency of chest pain and hemoptysis when compared to newly diagnosed and known diabetic patients. The symptom score was also lower in prediabetes (3.08) when compared to newly diagnosed (4) and known diabetic (3.79) patients. Atypical lung field involvement such as lower lobe infiltrates and lower lobe cavity were more significantly seen in newly diagnosed and known diabetic patients, when compared to prediabetes. Extensive radiological involvement in the form of multiple cavity, multi zonar and bilateral involvement were more commonly seen in newly diagnosed and known diabetic patients, when compared to prediabetes. There is no significant difference in the symptom score between the good control and poorly controlled diabetic groups. Multi zonar invovement, bilateral involvement and multiple cavities were more frequently seen in the poorly controlled diabetic group when compared to the well controlled diabetic group. CONCLUSION: Diagnosis of prediabetes at early phase is necessary so that primary prevention methods may be initiated timely. Strategies are needed to ensure that optimal care is provided to patients with both diseases: TB must be diagnosed early in people with diabetes, and diabetes must be diagnosed early in people with TB. Adequate glycemic control is very important in these patients, since poorly controlled diabetic patients tends to have far advanced disease involvement.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201727052 |
| Uncontrolled Keywords: | Tuberculosis, diabetes, clinico-radiological profile, lower zone involvement. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 04 Feb 2021 16:00 |
| Last Modified: | 04 Feb 2021 16:00 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13805 |
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