Abstract

Clinico-Radiological Profile of Pulmonary Tuberculosis with Diabetes Mellitus among Patients Attending to a Tertiary Care Teaching Hospital

Background: Diabetic patients are at higher risk of developing tuberculosis and the bi-directional association is a major concern for clinicians. The knowledge of the spectrum of disease in the Indian context is limited. Methods: A cross-sectional study was conducted on patients diagnosed with pulmonary tuberculosis and diabetes mellitus attending a tertiary care hospital in urban Telangana, India. Results: A total of 100 patients with tuberculosis were included in the study. The highest number of cases of tuberculosis with diabetes is prevalent in the 5th decade of their life. Nearly 80% of cases of tuberculosis are from urban areas and there is no significant difference in the association of diabetes with tuberculosis between urban and rural populations. More number of tuberculosis patients with diabetes (60%) are overweight compared to those without diabetes (20%). Lung infiltrations are the most common radiological presentation in both groups with a higher incidence in diabetic patients (82%) compared to non-diabetic tuberculous patients (62%). A higher number of acid-fast bacilli was observed on sputum microscopy in diabetic tuberculosis patients (3+ in 56%) while the majority of non-diabetic tuberculosis patients fall into the 1+ and 2+ categories. Patients with diabetes mellitus who consume a carbohydrate-rich diet, smoke, and consume alcohol had a higher association with tuberculosis. Conclusion: People with age more than 30 years were at higher risk for dual epidemic (DM-TB). Symptomatology was similar in both groups except that hemoptysis was observed more in patients with diabetes and TB. Family history of diabetes is an important clue for active DM screening in all TB patients and will help in the early detection of diabetes. Strategies are needed to ensure that optimal care is provided to patients with both diseases.

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