Objectives:
! To study the frequency of diabetes in patients with active pulmonary tuberculosis.
! To determine the impact of diabetes on radiological findings in tuberculosis.
! To study the association of atypical radiological manifestations with glycemic control in diabetes
associated tuberculosis.
Study Design:A Descriptive study.
Place and Duration of Study: The study was conducted in Medical Department of Pakistan Air Force Hospital
Mianwali from August 2013 to July 2014.
Materials and Methods: Seventy five new cases (18 years and above) of active pulmonary tuberculosis were
selected by non-consecutive convenient sampling. All patients received standard anti-tuberculous treatment
(ATT) for six months. Fasting blood glucose and chest X-ray were performed in all patients. Glycosylated
hemoglobin (HbA1c levels) were checked to assess the glycemic control in diabetic patients. Radiographic
features of the two groups; diabetic vs. non diabetic and within diabetic population; poor vs. optimal glycemic
control, were then compared.
Results: Thirty three (33/75 or 44%) patients were found to be diabetic. Radiological changes were more
frequently atypical in diabetic group as compared to non diabetic population (21/33 or 63.6% vs. 8/42 or 19%).
Nine of the 12 diabetic patients with poor glycemic control i.e. HbA1c levels >7% had cavitations, lower zone
involvement and bilateral changes as compared to 11/21 patients with optimal glucose control i.e. HbA1c <7%
and the difference was significant (9/12 or75% vs.11 /21 or 52.3%, p value <0.001).
Conclusion: A high index of suspicion for diagnosis of diabetes is required for TB patients with atypical
radiological manifestations. Poor glycemic control is related with atypical findings on chest X-ray in pulmonary
tuberculosis.
Shamaila Burney, Omer Awwab Khan, Saerah Iffat Zafar. (2016) Effect of Glycemic Control on Radiological Manifestations of Pulmonary Tuberculosis –A Hospital Based Study, , Volume-11, Issue-2.
