The Correlation of Chest Radiographic Image of Pulmonary Tuberculosis in Type 2 Diabetes Mellitus Patients with HbA1C Level


Globally, tuberculosis (TB) and diabetes mellitus (DM) are two significant factors of morbidity. Several studies show a bidirectional relation between these two diseases. Diabetes mellitus increases the risk of active TB infection. As a standard procedure, Glycated Hemoglobin (HbA1C) level is used for monitoring patients with DM. This study aimed to identify the correlation of chest radiographic image of pulmonary tuberculosis
with the HbA1C level in type 2 DM patients. A descriptive analytical survey with the cross-sectional study was performed in 32 subjects with type 2 DM and pulmonary TB. Statistical analysis was done by using gamma test, and we found a significant (p=0.042) and robust (r= 1) correlation between HbA1C level and pulmonary TB lesion area. It is concluded that chest radiographic images of pulmonary TB are significantly correlated
with the HbA1C level in patients with Type 2 DM.

Keywords: Chest radiography, pulmonary TB, HbA1C levels, DM

[1] Baghaei P. 2013. Diabetes mellitus and tuberculosis facts and controversies. J Diabetes Metab Disord 12(1) p 58

[2] Alisjahbana B. 2006. Diabetes mellitus is strongly associated with tuberculosis in Indonesia. International Journal of Tuberculosis and Lung Disease 10(6) pp 696– 700.

[3] Dobler CC, Flack JR and Marks GB. 2012. Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study. BMJ Open 2(1) pe000666[4] Guptan A and Ashok S. 2000. Tuberculosis and diabetes: an appraisal. Ind. J. Tub. 47(3) pp3–8

[5] Wijaya I. 2015. Tuberculosis paru pada penderita diabetes melitus. Cermin Dunia Kedokteran 42(6) pp 412–7

[6] Wulandari DR and Sugiri YJ. 2013. Diabetes mellitus dan permasalahannya pada infeksi tuberculosis. Jurnal respiratory Indonesia 33(2) pp126–34

[7] Chiang CY. 2015. The influence of diabetes, glycemic control, and diabetes-related comorbidities on pulmonary tuberculosis. PLoS ONE 10(3) p e0121698

[8] Higgins T. 2013. HbA1c for screening and diagnosis of diabetes mellitus. Endocrine.43(2) pp 266–73

[9] Ralph AP. 2010. A simple, valid, numerical score for grading chest x-ray severity in adult smear-positive pulmonary tuberculosis. Thorax 65(10) pp 863–9

[10] Patel AK, Rami KC and Ghanchi FD. 2011. Radiological presentation of patients of pulmonary tuberculosis with diabetes mellitus. Lung India? 28(1) p 70

[11] Rami H Fiona P Critchley JAand Laith J. 2017. Association between diabetes mellitus and active tuberculosis: A systematic review and meta-analysis. PLoS ONE 12(11): p e0187967

[12] Perhimpunan Dokter Paru Indonesia 2011 Pedoman penatalaksanaan TB (consensus TB). Perhimpunan Dokter Paru Indonesia. pp 1–55

[13] Chiang CY. 2014. Glycemic control and radiographic manifestations of tuberculosis in diabetic patients. PLoS ONE 9(4)

[14] Li-Kuo H Hsueh-Han W Yi-Chun L and Shi-Chuan C. 2017. The impact of glycemic status on radiological manifestations of pulmonary tuberculosis in diabetic patients. PLoS ONE 12(6): p e0179750

[15] Chang JT. 2011. Effect of type 2 diabetes mellitus on the clinical severity and treatment outcome in patients with pulmonary tuberculosis: a potential role in the emergence of multidrug resistance. J Formos Med Assoc;110(6) pp 372–81