Diabetes Metab J.  2013 Aug;37(4):291-295. 10.4093/dmj.2013.37.4.291.

Bidirectional Screening of Tuberculosis Patients for Diabetes Mellitus and Diabetes Patients for Tuberculosis

  • 1KLES Diabetes Centre, Belgaum, India. drmvjali@gmail.com
  • 2Department of Pulmonary Medicine, KLES Dr Prabhakar Kore Hospital & Medical Research Centre, Belgaum, India.
  • 3Faculty of Natural Sciences and Engineering, National Institute of Advanced Studies, Indian Institute of Science Campus, Bangalore, India.


To assess the feasibility and results of screening diabetes mellitus (DM) patients for tuberculosis (TB) and TB patients for DM within the routine health care setting. Prospective observational study carried out within the Diabetes Centre and Pulmonary Medicine Department from February 2012 to September 2012. The screening for active TB in DM and DM in TB patients is followed as per the guidelines of the Revised National Tuberculosis Control Programme and national programmes in India. Total of 307 patients diagnosed with TB during the study period. Among the TB patients 9.77% were smokers, 19.54% were known cases diabetes, and 15.96% were newly diagnosed cases of diabetes. Total of 4,118 diabetes patients were screened for TB in which 111 patients found to have TB. The strengths of this study are that we implemented screening within the routine health system. It is feasible to screen DM patients for TB resulting in high rates of TB detection.


Diabetes mellitus; India; Prevalence; Tuberculosis

MeSH Terms

Delivery of Health Care
Diabetes Mellitus
Mass Screening
Prospective Studies
Pulmonary Medicine


1. World Health Organization. Global tuberculosis report 2012. updated 2013 Mar 10. Available from: http://www.who.int/tb/publications/global_report/en/.
2. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011. 94:311–321.
3. World Health Organization. Diabetes: fact sheet number 312. updated 2013 Mar 1. Available from: http://www.who.int/mediacentre/factsheets/fs312/en/index.html.
4. Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med. 2008. 5:e152.
5. Ramachandran A, Ma RC, Snehalatha C. Diabetes in Asia. Lancet. 2010. 375:408–418.
6. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang YH, Stevens GA, Rao M, Ali MK, Riley LM, Robinson CA, Ezzati M. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 27 million participants. Lancet. 2011. 378:31–40.
7. Stop TB Initiative (World Health Organization). World Health Organization, Department of Chronic Diseases and Health Promotion. International Union against Tuberculosis and Lung Disease. Collaborative framework for care and control of tuberculosis and diabetes. 2011. Geneva: World Health Organization.
8. Li L, Lin Y, Mi F, Tan S, Liang B, Guo C, Shi L, Liu L, Gong F, Li Y, Chi J, Zachariah R, Kapur A, Lonnroth K, Harries AD. Screening of patients with tuberculosis for diabetes mellitus in China. Trop Med Int Health. 2012. 17:1294–1301.
9. Lin Y, Li L, Mi F, Du J, Dong Y, Li Z, Qi W, Zhao X, Cui Y, Hou F, Zachariah R, Kapur A, Lonnroth K, Harries AD. Screening patients with diabetes mellitus for tuberculosis in China. Trop Med Int Health. 2012. 17:1302–1308.
10. World Health Organization. Treatment of tuberculosis guidelines, 4th edition. updated 2013 Mar 10. Available from: http://whqlibdoc.who.int/publications/2010/9789241547833_eng.pdf.
11. Directorate General of Health Services, India. National programme for prevention and control of cancer, diabetes, cardiovascular disease and stroke (NPCDCS). updated 2013 Mar 10. Available from: http://health.bih.nic.in/Docs/Guidelines-NPCDCS.pdf.
12. Brostrom RJ. Summary of the impact of diabetes on tuberculosis control and submission of draft standards for diabetes and tuberculosis in the US-affiliated Pacific Islands. 2010. Paper presented at: Fifth Pacific Stop TB Meeting. 2010 May 4-7; Nadi, Fiji Islands. Nadi: Secretariat of Pacific Community.
13. Viswanathan V, Kumpatla S, Aravindalochanan V, Rajan R, Chinnasamy C, Srinivasan R, Selvam JM, Kapur A. Prevalence of diabetes and pre-diabetes and associated risk factors among tuberculosis patients in India. PLoS One. 2012. 7:e41367.
14. Balakrishnan S, Vijayan S, Nair S, Subramoniapillai J, Mrithyunjayan S, Wilson N, Satyanarayana S, Dewan PK, Kumar AM, Karthickeyan D, Willis M, Harries AD, Nair SA. High diabetes prevalence among tuberculosis cases in Kerala, India. PLoS One. 2012. 7:e46502.
15. Lindoso AA, Waldman EA, Komatsu NK, Figueiredo SM, Taniguchi M, Rodrigues LC. Profile of tuberculosis patients progressing to death, city of Sao Paulo, Brazil, 2002. Rev Saude Publica. 2008. 42:805–812.
16. Restrepo BI, Fisher-Hoch SP, Crespo JG, Whitney E, Perez A, Smith B, McCormick JB. Nuevo Santander Tuberculosis Tracker. Type 2 diabetes and tuberculosis in a dynamic bi-national border population. Epidemiol Infect. 2007. 135:483–491.
17. Jimenez-Corona ME, Cruz-Hervert LP, Garcia-Garcia L, Ferreyra-Reyes L, Delgado-Sanchez G, Bobadilla-Del-Valle M, Canizales-Quintero S, Ferreira-Guerrero E, Baez-Saldana R, Tellez-Vazquez N, Montero-Campos R, Mongua-Rodriguez N, Martinez-Gamboa RA, Sifuentes-Osornio J, Ponce-de-Leon A. Association of diabetes and tuberculosis: impact on treatment and post-treatment outcomes. Thorax. 2013. 68:214–220.
18. Jeon CY, Harries AD, Baker MA, Hart JE, Kapur A, Lonnroth K, Ottmani SE, Goonesekera S, Murray MB. Bi-directional screening for tuberculosis and diabetes: a systematic review. Trop Med Int Health. 2010. 15:1300–1314.
19. Jali MV, Mahishale V, Hiremath MB. Screen all patients with tuberculosis for diabetes. Curr Sci. 2013. 104:158.
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