Effects of Hyperglycemia on Presentations of Pulmonary Tuberculosis in Diabetic Patients

Abstract

Background: Diabetes Mellitus (DM) is a clinical syndrome characterized by chronic hyperglycemia and have multifactorial effects on immunity which increase the liability for infections with higher risk of lower respiratory tract infections including pulmonary tuberculosis (PTB).
Objective: To assess the effects of hyperglycemia in DM on the clinical, bacteriological and radiological presentations of pulmonary tuberculosis.
Methods: This study enrolled 25 tuberculous patients out of 310 diabetic patients who attend to the out-patient clinic of DM at Al- Diwaniya Teaching Hospital, they were studied during the period from 1st of October 2009 to 31st of March 2010. Results: This study revealed that male to female ratio was 4:1. 16% of the patients were type 1 DM, 56% were diabetic ≤10 years, 12% had fasting blood sugar (FBS) ≤6.9 mmol/l, 84% had HbA1c level ≥7.0%, 24% had positive history of pulmonary tuberculosis and 76% had positive sputum smear for acid fast bacilli (AFB). Multiple lobe involvement, cavitary lesions, lower lung field involvement and pleural effusion had been diagnosed in 64%, 60%, 32% and 16% of the sample respectively.
Conclusions: This study revealed that DM affects the clinical, bacteriological and radiological picture of PTB. Diabetic patients have a higher risk for recurrence of PTB.