STUDY THE PATTERN OF DRUG RESISTANCE IN PATIENTS OF PULMONARY TUBERCULOSIS HAVING DIABETES MELLITUS

Keshri Singh Yadav*, Balvir Singh, G. V. Singh and Bindu Rani

ABSTRACT

Introduction: As the pulmonary tuberculosis is still rampant in our country inspite of directly observed treatment short course( DOTS). Recently it has been observed that diabetic patients having pulmonary tuberculosis have more morbidity and mortality hence it gives us the impetus to know whether pulmonary tuberculosis is leading to development of diabetes. Hence we had undertaken this study to know the prevalence of diabetes in these early diagnosed pulmonary tuberculosis patients and assessing the pattern of drug resistance. Acute severe stress, fever, and malnutrition stimulate the stress hormones which is the cause of increased blood sugar level. Material and Methods: The study was done on 200 patients in the postgraduate department of Medicine and Tuberculosis and Chest Diseases, S.N. Medical College and Hospital, Agra. All newly diagnosed pulmonary tuberculosis patients who were non diabetics,nonsmokers and does not have any chronic disease were taken.These patients after detail clinical examination were adviced oral glucose tolerance test(OGTT) and sputum culture sensitivity and devided into group A,(euglycemic),B impaired glucose tolerance (IGT) and C(diabetic) on the basis of blood sugar level. Results: The prevalence of group B and C were 22.5% and 7.5% respectively.The development of multi drug resistance (MDR) tuberculosis accounted for nearly 37.5% in diabetics which is significantaly greater in comparison to IGT (33.3%) and nondiabetics (1.2%). Conclusionl: 1). The prevalence of frank diabetes and IGT in pulmonary tuberculosis is more than normal patients. 2). Response to therapy in the form of anti tuberculosis (ATT) has shown that some patients become euglycemic after 3 months of therapy. 3). MDR is more common in group C. 4). Group B and C patients have become acid fast bacilli (AFB) negative relatively later than group A.

Keywords: Diabetes, Pulmonary Tuberculosis, IGT, MDR, AFB.