High prevalence of diabetes and anthropometric heterogeneity among tuberculosis patients in Pakistan

Background In Pakistan, the prevalence of diabetes ( DM ) among adults is 6.9% and expected to double by 2040. DM may facilitate transmission and halter the elimination of tuberculosis ( TB ). We aimed to determine the prevalence of DM among patients with TB in Pakistan, and to investigate anthropometric biochemical and haemodynamic associations between TB patients with and without DM . Methods We conducted a cross‐sectional study at Gulab Devi Chest Hospital in Lahore, Punjab. A total of 3027 newly diagnosed smear‐positive TB patients ≥25 years of age were screened for DM by HbA1c regardless of previous DM history. Results The prevalence of screen‐detected DM and known DM among the TB participants was 13.5% and 26.1%, respectively, resulting in a combined DM prevalence of 39.6%. Most participants were male (64.4%). Using bivariate analyses, participants with DM were significantly older (49.8 vs . 40.6 years) with higher haemoglobin (men, 12.1 vs . 11.8 g/dl, women 11.5 vs . 10.7 g/dl), body mass index (21.0 vs . 17.6 kg/m 2 ) and waist–hip ratio (men, 0.87 vs . 0.81, women, 0.87 vs . 0.79) (all P < 0.05) than participants without DM . Stratifying by screen‐detected and known DM , these differences remained significant when using multivariate analysis. Conclusion We report a high prevalence of DM among patients with TB who may be anthropometrically and biochemically distinct from TB patients without DM , and this heterogeneity further transcends the different DM groups.