Impact of Diabetes on Clinical, Radiological, and Microbiological Parameters in Patients Suspected of Pulmonary Tuberculosis

Abstract

Objective: Diabetes mellitus is a documented risk factor that modifies the clinical course and severity of pulmonary tuberculosis. Therefore, this study compares the clinical presentation, radiological features, and microbiological findings of pulmonary tuberculosis patients with and without diabetes mellitus.

Methodology: This cross-sectional experimental study was conducted in institute of Basic Medical Sciences (IBMS), Khyber Medical University. A total of 103 patients aged ≥18 years diagnosed with pulmonary tuberculosis, categorized into two groups based on their diabetic status: with Diabetes (n = 52) and without Diabetes (n = 51), were included in the study. A chi-square test was used to examine the association of clinical, radiological and microbiological findings between both groups. Additionally, a Mann Whitney test was employed to analyze the relationship between the means of demographic variables between groups.

Results: The study findings showed that the diabetic patients more frequently reported weight loss 48(92.3%) vs. 39(76.5%) and reduced appetite 47(90.4%) vs. 33(64.7%). On chest X-ray, lower zone involvement was significantly higher in diabetics 29(55.8%), while non-diabetics showed more upper 16(31.4%) and middle zone 18(35.3%) opacities. CT findings similarly showed predominant lower zone disease in diabetics 28(53.8%) and greater upper zone involvement in non-diabetics 17(33.3%). Microbiological tests including AFB culture (28.8% vs. 25.5%) and ZN staining (26.9% vs. 25.5%), did not differ significantly between groups.

Conclusion: This study concluded that diabetic patients exhibited significantly higher rates of weight loss, reduced appetite, and a greater burden of lower-zone lung involvement on both CXR and CT imaging, whereas non-diabetic patients more frequently showed upper and middle zone abnormalities and mediastinal changes.