Objective: To assess feasibility and results of screening patients with tuberculosis (TB) for diabetes mellitus (DM) within the routine healthcare setting across the country at: eight tertiary care hospitals and more than 60 peripheral health institutions in eight tuberculosis units.
Methods: Agreement on how to screen, monitor and record was reached in October 2011 at a stakeholders' meeting, and training was carried out for staff in the facilities in December 2011 and January 2012. Implementation started from January 2012, and we report on activities up to 30 September 2012.
Results: Of 8269 TB patients diagnosed and initiated on treatment in participating facilities, 8109 (98%) were assessed for DM and 1084 (13%) were found to have DM; of these, 682 (8%) had a previously known diagnosis of DM and 402 (5%) were newly diagnosed. There was a higher prevalence of DM in patients with TB diagnosed in tertiary care hospitals (16%) than in those diagnosed in tuberculosis units (9%) (P < 0.001) and amongst those from South India (20%) than from North India (10%) (P < 0.001). The screening and referral process worked well although significantly more patients with DM diagnosed in hospitals were referred to DM care (96%) than patients diagnosed in tuberculosis units (92%) (P < 0.05).
Conclusion: This pilot project shows that it is important and feasible to screen patients with TB for DM in the routine setting, resulting in earlier identification of DM in some patients and opportunities for better management of comorbidity. A policy decision has since been made by the National TB Control Programme of India to implement this intervention countrywide.
© 2013 Blackwell Publishing Ltd.