Daily monitoring of diabetic treatment amongst TB-DM patients under NTEP: Does it improve the treatment outcomes?

Abstract

Problem considered: Directly Observed Treatment (DOT) has been the cornerstone for favorable outcomes in Tuberculosis treatment. Hitherto, the role of Diabetic DOT for TB-DM patients has not been explored in the present times when TB-DM dual epidemic has grown by significant proportions. The study aims to know the treatment outcomes in TB-DM patients under programmatic settings with or without DM treatment supervision and also to assess the concurrent glycemic control during the course of TB treatment. Methods: In this cohort study with nested case control design, total 102 TB-DM patients registered under National TB Elimination Programme of District Dakshina Kannada from July 2017 to March 2019 were enrolled. Systematic Diabetic Treatment monitoring was done in one geographical area whereas in other areas the monitoring was not done. Socio-clinico-demographic variables including glycemic control were analyzed. Results: The results showed that the treatment success rate was 92% in both intervention and non-intervention geographical areas. There was no association between the favorable TB treatment outcome amongst the TB DM patients and their demographic variables. A two-way repeated measure ANOVA with a Greenhouse Giesser correction determined that the mean value of HbA1c was statistically significant between assessment stages during the course of treatment and the interaction HbA1c and supervision arm had a significant effect. Conclusion: Diabetic DOT led to relatively better glycemic control (HbA1c) in TB-DM patients although in programmatic management of TB-DM patients, it did not have any significant effect on the TB treatment outcomes.

Keywords

• Glycemic control
• Monitoring
• Tuberculosis-diabetes