Socio-Clinical Determinants of Pattern of Glycated Haemoglobin among Tuberculosis Patients attending DOTS Clinic in North-Central Nigeria

Abstract

Background
Several factors such as obesity and smoking, among others, have been associated with deranged glycated haemoglobin (HbA1c) in TB patients. Hyperglycaemia, measured by HbA1c, showed a significantly higher risk of unfavourable TB treatment outcomes. This study examined the influence of some factors on HbA1c among TB patients attending the DOTS clinic of the University of Ilorin Teaching Hospital.

Methodology
A hospital-based cross-sectional study involving 180 consenting TB patients that were selected using systematic sampling technique from February to July 2022. Those with diagnosed Diabetes Mellitus were excluded. Data were collected using semi-structured questionnaires. Blood samples were collected for HbA1c estimation using turbidimetric method. HbA1c was categorized as DM (≥ 6.5%), prediabetes (HbA1c ≥ 5.7%–6.4%) and normal (< 5.7%) using American Diabetes Association criteria. Statistical Product and Service Solutions, version 23, was used to analyse data. P-value was < 0.05.

Results
The pattern of the HbA1c was normal (75%), pre-diabetes (8.9%), and DM (16.1%). The pattern of HbA1c was significantly associated with smoking (p = 0.037). Logistic regression analysis showed that smoking (OR = 0.240, 95% CI: 0.069–0.826) is less likely to predict suboptimal HbA1c (HbA1c ≥ 5.7%), but physical activity (OR = 1.877, 95% CI: 0.914–3.854) showed that those who are inactive were about two times at risk of developing suboptimal HbA1c. Body mass index, duration of treatment, HIV status, family history of DM, and type of TB had no statistically significant association with HbA1c.

Conclusion
A quarter of TB patients had deranged HbA1c (pre-diabetes and undiagnosed DM). This suggests the need for regular screening to mitigate the potential effects on their health. Physical activity protects against developing deranged HbA1c, and this emphasizes the need for TB patients to be active.