Study of clinical and radiological profile of pulmonary tuberculosis among patients having diabetes mellitus

Authors

  • Amrut Kumar Mohapatra Department of Pulmonary Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
  • Pratima Singh Department of Pulmonary Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
  • Saswat Subhankar Department of Pulmonary Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20174287

Keywords:

Blood Sugar, Cavitary and non-cavitary lesions, Immune system, Sputum bacteriology, Smear positive, Type I diabetes

Abstract

Background: Onset of tuberculosis is high among diabetic mellitus patients in relation to non-diabetic patients. Due to weakened immune system there is a greater risk of tuberculosis seen among type 2 diabetes mellitus patients. As a result, affected patients have difficulty in responding to any kind of treatment when compared to healthy individuals. The objective was to study the clinical and radiological profile of pulmonary tuberculosis among patients having diabetes mellitus (DM).

Methods: The study was conducted at the department of pulmonary medicine, in a tertiary health care centre in Eastern India. The study included smear positive pulmonary tuberculosis (PTB) patients with diabetes mellitus and the patients who were smear positive for pulmonary tuberculosis (control group) who met the criteria to participate in the study after a thorough examination. Informed written consent was obtained from all patients before enrolment.

Results: A total of 80 patients (15 to 65 years and above) were enrolled in the study with equal numbers being diagnosed with diabetes who had elevated blood sugar values (refer to Table 1). Classical clinical signs were totally correlated with radiography and 57.5% cases showed pulmonary lesions. Among the radiological findings, infiltration was most common in both groups, but more significant in PTB DM group (75 %) followed by cavity (52.5%) in PTB DM group.

Conclusions: It can be concluded from the study that in diabetic patients the pattern of pulmonary tuberculosis was significantly different from non-diabetic patients. Pre-treatment bacillary load was high in diabetic patients with pulmonary tuberculosis.

References

Smith I. Mycobacterium tuberculosis pathogenesis and molecular determinants of virulence. Clin Microbiol Rev. 2003;16(3):463-96.

WHO: Global tuberculosis control. 2011. Report No. 2011.16. Available at http://apps.who.int/iris/bitstream/10665/44728/1/9789241564380_eng.pdf.

Yad I, Pathan AJ. In: Iliyas M, Ed. Community Medicine and Public Health. 4th edition. Karachi: Time Reader, 1997:544-545.

Mugusi F, Swai AB, Alberti KG, McLarty DG. Increased prevalence of diabetes mellitus in patients with pulmonary tuberculosis in Tanzania. Tubercle. 2001;71:271-6.

Babu RV, Manju R, Kumar SV, Das AK. A comparative study of diabetes mellitus in pulmonary tuberculosis patients. World J Med Sci. 2013;9(2):93-6.

Xi Y, Bu S. Stem cells therapy in diabetes mellitus. J Stem Cell Res Ther. 2014;4(199):2.

Ullah H, Iqbal Z, Ullah, Mahboob A, Masood-ur-Rehman. Frequency of pulmonary tuberculosis in patients presenting with diabetes. Peshawar; 2009.

TB India 2014: Annual Status Report, RNTCP. CTD, MOH and FW, New Delhi. 2014. Available at http://www.tbcindia.nic.in/pdfs/TB%20 India.

Creswell J, Raviglione M, Ottmani S, Migliori GB, Uplekar M, Blanc L, et al. Tuberculosis and noncommunicable diseases: Neglected links and missed opportunities. Eur Respir J. 2011;37:1269-82.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-53.

Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: Pathogenesis, management, and relationship to glycaemic control. Diabetes Metab Res Rev. 2007;23:3-13.

Stegenga ME, van der Crabben SN, Blumer RM, Levi M, Meijers JC, Serlie MJ, et al. Hyperglycaemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia. Blood. 2008;112:82-9.

Webb EA, Hesseling AC, Schaaf HS, Gie RP, Lombard CJ, Spitaels A, et al. High prevalence of mycobacterium tuberculosis infection and disease in children and adolescents with type 1 diabetes mellitus. Int J Tuberc Lung Dis. 2009;13(7):868-74.

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Published

2017-09-22

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Original Research Articles