Evaluation of First-Line Anti-Tuberculosis Treatment Based on Radiological Findings in Pulmonary Tuberculosis Patients with Diabetes Mellitus at Persahabatan Hospital

Abstract

Background: Indonesia has a high prevalence of pulmonary tuberculosis (TB) and diabetes mellitus (DM),. Pulmonary TB is an infectious disease caused by Mycobacterium tuberculosis, which is transmitted via droplets inhaled by individuals near active TB patients. Diabetes mellitus is an independent risk factor for TB infection and can increase the risk of latent TB reactivation due to a weakened immune system. The coexistence of TB and DM can impair the absorption of first-line anti-tuberculosis drugs (OAT) because of gastrointestinal motility disorders and altered intestinal permeability caused by neuropathy and hyperglycemia in DM patients. This condition makes patients more vulnerable to treatment failure, relapse, and increased mortality.

Methods: This study employed an analytical observational design with a cross-sectional approach using 86 medical records of pulmonary TB patients with DM, selected through simple random sampling.

Results: Most patients were adults aged 18–59 years (66.3%) and male (55.8%), with the majority having uncontrolled blood glucose levels (75.6%) and normal nutritional status (38.4%). The most common treatment duration was nine months (76.7%). All patients showed clinical improvement and sputum conversion (100%), while radiological improvement was observed in 81.4% of patients. Bivariate analysis demonstrated a significant difference in radiological improvement between patients with controlled and uncontrolled DM (p= 0.009).

Conclusion: The majority of pulmonary TB patients with DM were aged 18–59 years, male, and had uncontrolled blood glucose levels. All patients showed clinical improvement and sputum conversion, while 81.4% experienced radiological improvement, with a significant difference between controlled and uncontrolled DM.