National guidelines on screening for diabetes among patients with tuberculosis in India: Need for clarity and change in screening cut off?
Globally, diabetes contributes to 15% of TB burden and is a risk factor for unfavourable TB treatment outcomes
Abstract
Globally, diabetes mellitus (DM) contributes to 15% of tuberculosis (TB) burden and is a risk factor for unfavourable TB treatment outcomes. A TB-DM collaborative framework was launched in 2011 by the World Health Organization and International Union Against Tuberculosis and Lung Disease with bidirectional screening of TB-DM as one component.
India is world’s diabetes capital after China and has the highest burden of TB. A policy decision to screen all TB patients within the programme for DM was taken in 2012.The detailed guidance has been provided in the ‘National framework for joint TB-Diabetes collaborative activities’ (2017). According to these, a patient with TB should be screened for random blood glucose (RBG) using a glucometer, which can be interpreted as random capillary blood glucose (RCBG). If RCBG is ≥7.8 mmol/l (140 mg/dl), then the patient should be offered fasting blood glucose (FBG). If FBG is ≥7.0 mmol/l (126 mg/dl) then s/he is referred to the nearest facility for definitive (confirmatory) diagnosis and management of DM.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Shewade HD, Jeyashree K, Mahajan P, Kumar AMV. National guidelines on screening for diabetes among patients with tuberculosis in India: Need for clarity and change in screening cut off? Diabetes & metabolic syndrome. 2017; [Epub ahead of print]