Siddiqui Ali Nasir, Khayyam Khalid Umer, Siddiqui Nahida, Sarin Rohit, Sharma Manju
Department of Pharmaceutical Medicine, Faculty of Pharmacy, Hamdard University, New Delhi, India.
Department of Epidemiology & Public health, National Institute of TB and Respiratory Diseases, New Delhi, India.
Trop Med Int Health. 2017 Nov;22(11):1394-1404. doi: 10.1111/tmi.12968. Epub 2017 Oct 9.
To determine the prevalence of diabetes mellitus (DM), assess its influence on health-related quality of life (HRQoL) among patients with TB.
In this prospective study, eligible patients at three primary healthcare centres in urban slum region of south Delhi, India, underwent blood glucose screening at treatment initiation. HRQoL scores were determined by conducting face-to-face interviews using Dhingra and Rajpal (DR-12) scale at pre-treatment, end of intensive phase and end of the treatment.
In 316 patients, the overall DM prevalence was 15.8%, of whom 9.5% were known to have diabetes, and 6.3% were diagnosed at TB treatment initiation. DM was more common among patients of older age (P < 0.001), with higher BMI (P < 0.001), with PTB (P = 0.02) and with poor psychological status. HRQoL was significantly poor in the socio-psychological & exercise adaptation domain in patients with DM ˃50 years of age at each visit. Older age, poor literacy, loss in workdays, alcohol use and socio-economic status significantly predict poor HRQoL scores in patients with DM. Uncontrolled DM patients demonstrated poor HRQoL at the end of the intensive phase (P = 0.04) of treatment and at its completion (P = 0.03) compared to those with controlled DM.
Addressing screening measures and glycaemic control along with social determinants such as literacy level and alcohol consumption could be an important means of improving the HRQoL of TB with DM patients.
确定糖尿病（DM）的患病率，评估其对结核病患者健康相关生活质量（HRQoL）的影响。
在这项前瞻性研究中，印度新德里南部城市贫民窟地区三个初级医疗中心的符合条件的患者在开始治疗时接受血糖筛查。在治疗前、强化期结束时和治疗结束时，使用Dhingra和Rajpal（DR - 12）量表通过面对面访谈确定HRQoL得分。
在316名患者中，DM总体患病率为15.8%，其中9.5%已知患有糖尿病，6.3%在开始结核病治疗时被诊断出患有糖尿病。DM在年龄较大（P < 0.001）、BMI较高（P < 0.001）、患有肺结核（PTB，P = 0.02）和心理状态较差的患者中更为常见。在每次就诊时，年龄大于50岁的DM患者在社会心理和运动适应领域的HRQoL明显较差。年龄较大、文化程度低、工作日损失、饮酒和社会经济地位显著预测DM患者的HRQoL得分较差。与DM得到控制的患者相比，DM未得到控制的患者在治疗强化期结束时（P = 0.04）和治疗结束时（P = 0.03）的HRQoL较差。
采取筛查措施和血糖控制，同时考虑文化程度和饮酒等社会决定因素，可能是改善合并DM的结核病患者HRQoL的重要手段。
