Background: Association of diabetes and tuberculosis (TB) has been reported in various literatures globally. Recently there has been increasing mortality in diabetic patients infected with TB. Thus, the present study was undertaken to find out the prevalence of TB in diabetic patients, symptoms, smoking status and radiological patterns of TB in diabetic subjects.

Methods: 500 diabetics patients were screened for the presence of TB and out of these 56 patients affected with TB were designated as cases (DM-TB). Meanwhile aged matched non diabetic TB patients were designated as controls (Non DM-TB). The parameters like symptoms, smoking history, sputum positivity and X-ray pattern were evaluated.

Results: In this study the prevalence of TB in diabetics was found to be 11.2%. The male subjects were higher in both the groups. The most common symptoms in both the groups were cough, fever and breathlessness. The male smokers were significantly (P<0.005) higher in DM-TB as compared to the Non DM-TB. The sputum positivity for AFB was higher in DM-TB as that of the Non DM-TB (p>0.005). The chest X-ray displays more bilateral infiltration pattern of lesions and bronchiectasis and multiple zones of lesion in DM-TB group.

Conclusion: Thus early screening for TB in diabetes is highly vital for better treatment outcome and to reduce the mortality.

Keywords: Diabetes, tuberculosis, smoking, respiratory symptoms, acid fast bacilli, chest X-ray.

1. Smith I: Mycobacterium tuberculosis pathogenesis and molecular determinants of virulence. Clin Microbiol Rev. 2003, 16 (3): 463-496.
2. WHO: Global tuberculosis Report. 2018.
3. Global TB Report 2017”, WHO, 2017
4. Sen T, Shashank R, Zarir F: Tuberculosis and Diabetes Mellitus: Merging Epidemics. J Assoc Physicians India. 2009, 57: 62-65.
5. World Health Organization. Global report on diabetes. Geneva, Switzerland: WHO, 2016. Available from: http:// www.who.int/ diabetes/ global-report/ WHD16-press-release-EN_3.pdf?ua=1
6. https://www.idf.org/our-network/regions-members/south-east-asia/members/94-india.html
7. Baker MA, Anthony D, Harries AD, Jeon CY, Hart JC, Kapur A, Lönnroth K, Ottmani SE, Goonesekera SD, Murray MB: The impact of diabetes on tuberculosis treatment outcomes: a systematic review. BMC Med 2011, 9:81.
8. Pérez A, Brown HS, Restrepo BI: Association between tuberculosis and diabetes in the Mexican border and non-border regions of Texas. AmJTrop Med Hyg 2006, 74(4):604–611.
9. Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med. 2008;5(7).
10. García-Elorriaga G, Del Rey-Pineda G. Type 2 diabetes mellitus as a risk factor for tuberculosis. J Mycobac Dis 2014; 4: 144.
11. Stevenson CR, Forouhi NG, Roglic G, Williams BG, Lauer JA, Dye C, et al. Diabetes and tuberculosis: the impact of the diabetes epidemic on tuberculosis incidence. BMC Public Health. 2007;7:234.
12. A. Tawfiq, B.M. Saadeh, Radiographic manifestations of culture-positive pulmonary tuberculosis: cavitary or non-cavitary?, Int J. Tuberc. Lung Dis. 12 (3) (2009) 367–370.
13. Lalit K. Diabetes mellitus and tuberculosis the brewing double trouble. Indian Journal Tuberculosis New Delhi 2003; 50(Suppl. 4): 1-2.
14. Kumar A, Gupta D, Burugina S, Nair A, Satyanarayana S, Kumar AM, et al. Screening of patients with diabetes mellitus for tuberculosis in India. Trop Med Int Health 2013; 18(5): 646-54.
15. Agarwal AK, Gupta G, Marskole P, Agarwal A. A study of the patients suffering from tuberculosis and tuberculosis-diabetes comorbidity in Revised National Tuberculosis Control Program Centers of Northern Madhya Pradesh, India. Indian J Endocr Metab 2017;21:570-6
16. Siddiqui AN, Khayyam KU, Sharma M. Effect of diabetes mellitus on tuberculosis treatment outcome and adverse reactions in patients receiving directly observed treatment strategy in India: A prospective study. Biomed Res Int 2016: 7273935, 2016
17. Baghaei P, Marjani M, Javanmard P, Tabarsi P, Masjedi MR. Diabetes mellitus and tuberculosis facts and controversies. J Diabetes MetabDisord 12: 58, 2013.
18. Kumpatla S, Sekar A, Achanta S et al. Characteristics of patients with diabetes screened for tuberculosis in a tertiary care hospital in South India. Public Health Action 3 [Suppl 1]: S23-S28, 2013.
19. Viswanathan V, Kumpatla S, Aravindalochanan V et al. Prevalence of diabetes and pre-diabetes and associated risk factors among tuberculosis patients in India. PLoS One 7: e41367, 2012.
20. Bacakoglu F, Baroglu OK, Lok G, SayinerA, Ates M. Pulmonary TB in patients with diabetes mellitus. Respiration. 2001;68:595-600.
21. AL Wabel AH, Teklu B, Mahfoz AA.al-Ghamli AS, Amin OB, Khan AS. Symtomatology and chest roentegenographic changes of pulmonary tuberculosis among diabetics. East Afr Med J. 1997;74(2):62-4
22. Sarker M, Barua M, Guerra F et al. Double trouble: prevalence and factors associated with tuberculosis and diabetes comorbidity in Bangladesh. PLoS One 11: e0165396, 2016.
23. Agarwal AK, Ginisha G, Preeti G, Dwivedi S, Swamai P. The association between diabetes and tuberculosis may be the next challenge for global tuberculosis control worldwide. Indian J Endocrinol Metab 20: 732-733, 2016
24. Goldhaber-Fiebert JD, Jeon CY, Cohen T, Murray MB. Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants. Int J Epidemiol 40: 417-428, 2011.
25. Singla R, Khan N, Al-Sharif N, Ai-Sayegh MO, Shaikh MA, Osman MM. Influence of diabetes on manifestations and treatment outcome of pulmonary TB patients. Int J Tuberc Lung Dis. 2006;10(1):74- 9.
26. Perez-Guzman AC, Torres-Cruz H, Villarreal Velarde MA, Salazar-Lezama MH, Vargas. Atypical radiological images of pulmonary tuberculosis in 192 diabetic patients: a comparative study. Int J Tuberc Lung Dis. 2001;5(5):455-61.
27. Jalamkar OD, Salve VT. Screening of diabetic respiratory symptomatics for pulmonary TB: a key to tackle another hurdle in patient care and TB control?. Int J Community Med Public Health 2017;4:2282-93.

Dr C. Vaishnavi Priyaa

Assistant Professor, Medical Gastroenterology, Department of Digestive Health and Diseases, Government

Peripheral Hospital, Annanagar, Chennai, India

Phone: 9941251197, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.