Study of pulmonary tuberculosis in type 2 diabetes in reference to clinical, radiological presentation and response to treatment

Background: Tuberculosis is the third most important communicable disease in Egypt follows the schistosomiasis and hepatitis C (WHO, 2010) [1]. The association between TB and DM has been known for thousands of years, Although the incidence of TB is declining slowly, the burden of diabetes is increasing very rapidly, many studies have been performed to answer about the effect of type 2 DM in clinical, radiological presentation and the outcome of pulmonary tuberculosis, however there is still a huge gap of knowledge about the synergetic effect of the two diseases (Kapur et al., 2013) [2]. Patients and methods: A combined cohort study was conducted during the period between September 2016 and March 2017 (prospective part) on 50 adult patients with active pulmonary tuberculosis with sputum positive with comorbidity type 2 DM; and (50) adult patients with only pulmonary tuberculosis diagnosed by positive sputum smear (retrospective part). All patients admitted to El Mahalla chest hospital and DOTs centers in it; and also beside comparison between the (50) DMTB patients with other (20) adult patients with only diabetes mellitus admitted to El-Mahalla chest hospital for another reasons rather than pulmonary tuberculosis. Results: DMTB patients were older in age, type 2 DM hasn't affected clinical presentation and lesions site in X-rays, but DMTB patients had more than one type of lesions in the same X-ray, with more incidence of pleural extension; type 2 DM hasn't affected the outcome results but DMTB patients showed delay in the smear conversion and response to treatment comparing to patients with pulmonary TB only, and type 2 DM is not a independent risk factors for pulmonary TB without others risk factors such as smoking. Conclusion: Type 2 DM has no effect in the clinical presentation or the outcome of pulmonary TB, but may presented with atypical radiological presentation in presence of more than one lesion type in the same radiological film and presence of extra pleural extension; and type 2 DM is not an independent risk factors of pulmonary TB.