The epidemiology of intransient TB-induced hyperglycaemia in previously undiagnosed diabetes mellitus 2 individuals: a protocol for a systematic review and meta-analysis

Sonia Menon, Joel Francis, Natasha Zdraveska, Alfred Dusabimana, Samit Bhattacharyya

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Abstract

Background Diabetes mellitus (DM) is burgeoning as a global chronic health condition. Some studies suggest that tuberculosis (TB) can even cause diabetes in those not previously known to be diabetic, which as a corollary can add to the already heavy global DM burden. The World Health Organization (WHO) recommends screening for DM at the start of TB treatment; however, it remains to be elucidated which patients with TB-induced hyperglycaemia are at risk for developing DM and who would benefit from a more regular follow-up. This systematic review will aim to firstly synthesise literature on the irreversibility of TB-induced hyperglycaemia in individuals with previously undiagnosed type 2 diabetes mellitus and secondly to synthesise literature on risk factors for progression from TB-induced hyperglycaemia to overt DM in previously undiagnosed. Methods We will search for relevant studies in electronic databases such as PubMed, EMBASE, PROQUEST, and SCOPUS. Furthermore, references will be hand searched to identify other studies. A flow diagram will be drawn to identify the studies retrieved from each database. We will review all publications that include studies containing data on impaired glucose metabolism upon TB diagnosis, and the quality of all eligible studies will be assessed using the Newcastle-Ottawa Scale. We will further conduct a meta-analysis to pool estimates on the risk of progression of persistent hyperglycaemia to overt DM within this population group, as well as the risk factors for this progression. We will use a random effect model to assess heterogeneity, will carry out sensitivity analysis to explore the influence of a single study on the overall estimate, and will report our findings from our systematic review and meta-analysis according to PRISMA guidelines. Egger's test will be performed to explore the presence of selective reporting bias. If data allow, we will perform a subgroup/meta-regression analysis. Summary effects will be reported using odds ratio, hazard ratio, and relative risk ratios. Furthermore, any clinical, epidemiological, and public health research gaps we identify will be described in a research proposal.

Original languageEnglish
Article number234
JournalSystematic Reviews
Volume8
Issue number1
Pages (from-to)234
Number of pages5
ISSN2046-4053
DOIs
Publication statusPublished - 2019

Keywords

  • Tuberculosis
  • Diabetes mellitus
  • Intransient hyperglycaemia
  • Protocol
  • TUBERCULOSIS
  • RISK
  • ASSOCIATION
  • INCREASES
  • MORTALITY

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