Relationship of Tuberculosis Radiographic Manifestation in Diabetic Patients with HbA1c Levels

Dana Jauhara Layali, Bintang YM Sinaga, Parluhutan Siagian, Putri Chairani Eyanoer


Background: The relationship between diabetes mellitus (DM) and tuberculosis (TB) is a significant health problem and more prominent in developing countries where TB is endemic and DM prevalence increases. The prevalence of pulmonary TB increases with increasing prevalence of DM. Uncontrolled diabetic patients with high hemoglobin (HbA1c) levels cause TB to become more severe and are associated with higher mortality and also have a significant effect on radiological manifestations of pulmonary TB.
Methods: The was a case-control study conducted between January to December 2016 at RSUP H Adam Malik, Medan to 43 with TB-DM patients and 41 TB-without DM patients was studied from. Radiological examination with chest radiograph was done in both groups of samples. The HbA1c levels was examined in the TB with DM group.
Result: Compared with TB-without DM group, the TB with DM group significantly had far advanced tuberculosis lesions (OR=3.8; 95% CI=1.37-10.47; P=0.01), more atypical lesions atipikal (OR=6.29; 95% CI=2.43-16.25; P<0.01), more multiple cavity (OR=15; 95% CI=2.52-133.26; P=0.002). TB patients with HbA1c 7-8.9% had a 14.25 times to having atypical lesions compared with HbA1c <7 g% (OR=14.25; 95% CI=1.41–143.18; P= 0.024).
Conclusion: Diabetes mellitus especially uncontrolled DM has an impact to the radiological imaging of TB. (J Respir Indo. 2019; 39(3):154-9)


Tuberculosis, diabetes mellitus, HbA1c, radiograph

Full Text:



World Health Organization (WHO). Global Tuberculosis Report. Geneva. 2013:10-17. Diunduh dari

World Health Organization (WHO). Global Tuberculosis Report. Geneva. 2016:15-21. Diunduh dari

Baghaei P, Marjani M, Javanmard P, Tabarsi P, Masjedi MR. Diabetes mellitus and tuberculosis facts and controversies. J Diabetes Metab Disord. 2013;12:58.

Dobler CC, Flack JR, Marks GB. Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study. BMJ Open 2012;2(1):1-8.

Chiang CY, Lee JJ, Chien ST, Enarson DA, Chang YC, Chen YT, et al. Glycemic control and radiographic manifestations of tuberculosis in diabetic patients. PLoS One. 2014;9(4):e93397.

Hossain M, Ahmed J, Afroz F. A comparison of clinical, radiological, and bacteriological characteristic of pulmonary tuberculosis in diabetic and non-diabetic patients. Chest. 2016;149(4):A73.

Wijaya I. Tuberkulosis paru pada pasien diabetes mellitus. Cermin Dunia Kedokt. 2015;42(6):412-6.

Cahyadi A, Venty. Tuberkulosis paru pada pasien diabetes mellitus. J Indon Med Assoc 2011;6(4):173-8.

Elorriaga G, Pineda DR. Type 2 diabetes mellitus as a risk factor for tuberculosis. J Mycobac Dis. 2014;4(2):1-6.

Shital P, Anil J, Sanjay M, Mukund P. Tuberculosis with diabetes mellitus: clinical-radiological overlap and delayed sputum conversion needs cautious evaluation-prospective cohort study in tertiary care hospital, India. J Pulm Respir Med. 2014;4(2):1-5.

Perez-Guzman C, Torres-Cruz A, Villarreal-Velarde H, Vargas MH. Progressive age-related changes in pulmonary tuberculosis images and the effect of diabetes. Am J Respir Crit Care Med. 2000;162:1738-40.

Singh SK, Tiwari KK. Clinicoradiological profile of lower lung field tuberculosis cases among young adult and elderly people in a teaching hospital of Madhya Praresh, India. J Trop Med. 2015:1-7.

Bokam BR, Thota P. Effect of glycemic control on pulmonary tuberculosis in diabetics. Indian Journal of Basic and Applied Medical Research. 2016;5(3):198-207.



  • There are currently no refbacks.

Copyright (c) 2019 Jurnal Respirologi Indonesia


SINTA Garuda Indonesian Scientific Journal Database (ISJD) Indonesia One Search (IOS) Crossref

ROAD-ISSN Dimensions Google Scholar 


Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845

An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License