Department of Respiratory Medicine, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India.
Department of Pulmonary Medicine, Ispat General Hospital, Rourkela, Odisha, India.
Int J Mycobacteriol. 2021 Jul-Sep;10(3):268-270. doi: 10.4103/ijmy.ijmy_133_21.
The association between diabetes mellitus (DM) and tuberculosis (TB) and their synergistic role in causing human disease has been recognized for centuries. Despite the known synergy between DM and TB, the importance of atypical clinical, radiological presentation and DM as a risk factor for TB is largely unknown. This study was undertaken to know the effect of glycemic control on TB manifestations as it will contribute to the opportunities for detection and treatment of both disease conditions appropriately.
This cross-sectional study included 50 patients attending the pulmonary medicine department in Ispat General Hospital with pulmonary TB and DM during 6 months' period. Clinical data, chest-X ray, HbA1c values were obtained and the effect of glycemic control studied and analyzed.
Five patients had good glycemic control (HbA1c ≤7%), 45 patients had poor glycemic control (HbA1c >7%). Cough was present in all patients. Weight loss and night sweats were present in poor glycemic group and sputum smear grade was higher in higher HbA1c patients and both were statistically significant. None of the good glycemic group had lower zone lesion. The commonest type of lesion was nonhomogenous opacity, followed by cavities in both poor and good glycemic groups. Cavities were usually present in lower zones. Size and number of cavities were more as the glycemic control is poor. So, that glycemic control did have an effect on pulmonary TB manifestations, hence achieving and maintaining glycemic control is necessary for DM with pulmonary TB.
糖尿病（DM）和结核病（TB）之间的关联及其在导致人类疾病方面的协同作用已被认识了几个世纪。尽管已知 DM 和 TB 之间存在协同作用，但 DM 作为 TB 的一个风险因素，其不典型的临床表现和放射学表现的重要性在很大程度上仍未被认识。本研究旨在了解血糖控制对 TB 表现的影响，因为这将有助于有机会适当检测和治疗这两种疾病。
这是一项横断面研究，纳入了在伊斯帕特总医院接受肺病治疗的 50 例患有肺结核和糖尿病的患者，研究时间为 6 个月。获得了临床数据、胸部 X 射线、HbA1c 值，并研究和分析了血糖控制的效果。
5 例患者血糖控制良好（HbA1c ≤7%），45 例患者血糖控制不佳（HbA1c >7%）。所有患者均有咳嗽。体重减轻和夜间出汗仅见于血糖控制不佳组，且 HbA1c 较高的患者痰涂片分级较高，两者均具有统计学意义。良好血糖控制组中无一例出现下区病变。最常见的病变类型为不均匀混浊，其次是空洞，无论是在血糖控制良好还是不佳的组中。空洞通常出现在下区。随着血糖控制的恶化，空洞的大小和数量会更多。因此，血糖控制确实对肺结核表现有影响，因此对于患有肺结核的糖尿病患者，控制血糖是必要的。
