The dual burden diabetes and tuberculosis among women and men with low adiposity in rural South India

Abstract Number Theme Presentation Type Cover Approved
0509 Micronutrients, overweight and obesity Poster Not Approved


Abstract Content


Increased adiposity is a major risk factor for diabetes mellitus (DM) and pre-diabetes. Tuberculosis (TB) is associated with wasting and altered body composition. As dual epidemics of communicable and non-communicable diseases collide in many settings including India, little is known about the interplay of TB and disordered glucose metabolism among patients with lower body weight.


Adult outpatients (= 18 years) presenting with clinical signs and symptoms of tuberculosis were recruited at a former TB sanatorium in India (n=290). Active TB was assessed by acid-fast bacilli sputum smear microscopy. DM (HbA1c =6.5%) and pre-DM (HbA1c <5.7% to =6.5%) were defined by concentrations of glycated hemoglobin (HbA1c) determined by high-performance liquid chromatography. Whole and segmental body composition was measured by bioelectrical impedance analysis.


More than one out of every four women had DM (9.0%) or pre-DM (18.0%). About one of every three men had DM (14.4%) or pre-DM (22.1%). Among all study participants, 10.7% had active TB. A greater prevalence of men (16.0%) had active TB, compared to women (2.2%; p<0.05). Median body mass index were similar between males (18.3 kg/m2 [IQR 16.2-20.6]), and females (19.0 kg/m2 [IQR 16.0-22.4]; p>0.05). DM prevalence was significantly higher in patients with TB (22.6%), compared to patients without TB (8.8%; p<0.05).


Findings support the need for prospective studies to elucidate clinical and immunological consequences of this comorbidity, and incorporate screening for DM in TB management programs.

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