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HIGH PREVALENCE AND HETEROGENEITY OF DYSGLYCEMIA IN PATIENTS WITH TUBERCULOSIS FROM PERU: A PROSPECTIVE COHORT STUDY
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Abstract
The accuracy of different laboratory tests for diagnosis of diabetes mellitus (DM) and prediabetes (preDM) in populations exposed to tuberculosis (TB) remains poorly understood. Here, we examined the prevalence of DM and preDM in TB affected people in Lima, Peru. Methods: A prospective cohort study of patients affected TB and their household contacts (HHC), was conducted
between February and November 2017 in Lima, Peru. Fasting plasma glucose (FPG), HbA1c and oral glucose
tolerance test (OGTT) were used to detect DM and preDM in a prospective cohort of TB patients (n = 136) and
household contacts (n = 138). Diagnostic performance of the laboratory tests was analyzed. Potential effects of
sociodemographic and clinical factors on detection of dysglycemia were analyzed.
Results: In TB patients, prevalence of DM and preDM was 13.97 and 30.88% respectively. Lower prevalence of both
DM (6.52%) and preDM (28.99%) were observed in contacts. FPG, HbA1c and OGTT had poor agreement in
detection of preDM in either TB cases or contacts. TB-DM patients had substantially lower hemoglobin levels, which
resulted in low accuracy of HbA1c-based diagnosis. Classic sociodemographic and clinical characteristics were not
different between TB patients with or without dysglycemia.
Conclusion: High prevalence of DM and preDM was found in both TB patients and contacts in Lima. Anemia was
strongly associated with TB-DM, which directly affected the diagnostic performance of HbA1c in such population.
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