Clinico-radiological profile and treatment outcome of pulmonary tuberculosis with and without type 2 diabetes mellitus

The bidirectional association between tuberculosis (TB) and diabetes mellitus (DM) is currently one of the major concerns for clinicians, as DM affects the disease presentation and clinical outcome of TB and vice versa. The interest in diabetes mellitus and tuberculosis is mounting rapidly and it promises to be an exciting time for researchers involved in the study of dual diseases. A prospective case control study was conducted over a period of one year, on patients diagnosed with pulmonary tuberculosis (PTB) with and without associated type 2 diabetes mellitus, who were admitted in a tertiary care hospital. Pulmonary TB patients with diabetes were labelled as the case group, and those without diabetes were labelled as the control group. A total number of 63 patients in the case group were compared with 63 patients in the control group. In the present study, clinical symptoms were similar in both the case and control groups, except for haemoptysis (27% vs. 12.7%) and weight loss (96.8% vs. 84.1%), which were significantly more predominant in the case group. There was a significant radiological involvement of the lower lung fields (46% vs. 17.5%) with cavitations (42.9% vs. 20.6%) in the case versus the control group. The sputum conversion at the end of the 2nd month was 92.1% in the control group and 55.6% in the case group (p = 0.001). In addition, cure rate in the control group was notably higher than in the case group (81% vs. 61.9%). The proportion of treatment failures were more among the case group (14.3%) as compared to the control group (1.6%). The present study concludes that, diabetes certainly affects the clinical, bacteriological and radiological presentation and treatment outcome of pulmonary tuberculosis. • This study highlights the impact of Diabetes Mellitus on the clinical and radiological presentation of Tuberculosis. • Present study also emphasizes that diabetes evidently adversely affects the treatment outcomes of TB, underlying the need for diagnosis of coexisting DM among pulmonary TB patients and vice versa. • Our study clearly suggests the need for a bidirectional screening of TB and DM. • The lower zone involvement with cavitation on chest X-ray in presumptive pulmonary tuberculosis should raise the possibility of coexisting diabetes.