Chest X-Ray Findings in Patients with Tuberculosis and Diabetes Mellitus at Prof. Dr. Chairuddin P. Lubis Hospital, Medan
DOI:
https://doi.org/10.59141/-.v8i2.576Keywords:
Tuberculosis, Diabetes mellitus, Chest X-ray, Radiological findings, Pulmonary lesionsAbstract
Pulmonary tuberculosis (TB) and diabetes mellitus (DM) are major global health burdens with significant bidirectional interactions. DM increases the risk of developing active TB and may influence its radiographic presentation, often resulting in atypical findings. Chest radiography remains an essential diagnostic tool for evaluating patients with TB and DM. This study aimed to describe the chest radiographic findings among patients with TB and DM at Prof. Dr. Chairuddin P. Lubis Hospital, Universitas Sumatera Utara, Medan. This retrospective descriptive study analyzed secondary data from 124 patients with TB and DM who underwent chest radiography in 2024. Data were analyzed using univariate descriptive statistics to determine the distribution of radiographic findings. Most patients were male (54.8%). Pulmonary infiltrates were the most common finding (83.9%), followed by fibrosis (34.7%), consolidation (27.4%), cavitation (15.3%), calcification (11.3%), and pleural effusion (8.1%). No cases of miliary opacities or tuberculomas were identified. Based on the radiographic extent of pulmonary lesions, moderately advanced disease predominated (74.2%), while minimal and far-advanced disease were observed in 16.1% and 6.5% of patients, respectively. Patients with TB and DM most frequently exhibited pulmonary infiltrates and moderately advanced disease on chest radiographs. The absence of miliary patterns and tuberculomas further illustrates the variability of radiographic manifestations of TB in patients with DM. Comprehensive chest radiographic assessment remains important for identifying atypical pulmonary TB manifestations and supporting timely clinical diagnosis.
Downloads
References
Abd El-Hamid El-Kady, R., & Turkistani, S. A. (2021). The footprint of diabetes mellitus on pulmonary tuberculosis. Infection and Drug Resistance, 14, 5303–5312.
Amelia, R., Fujiati, I. I., Lindarto, D., Yunir, E., & Kusnanto, H. (2024). Profile of tuberculosis patients with comorbid diabetes mellitus in Medan, Indonesia. Pan African Medical Journal, 49, 54.
Amin, S., Khattaq, M. I., Shabbier, G., & Wazir, M. N. (2011). Frequency of pulmonary tuberculosis in patients with diabetes mellitus. Gomal Journal of Medical Sciences, 9(2), 163–165.
Cáceres, G., Calderon, R., & Ugarte-Gil, C. (2022). Tuberculosis and comorbidities: Treatment challenges in patients with comorbid diabetes mellitus and depression. Therapeutic Advances in Infectious Disease, 9, 20499361221095831. https://doi.org/10.1177/20499361221095831
Cahyadi, M. R., Soekardi, A., & Pratama, I. H. (2024). Hubungan derajat lesi radiografi thoraks pada pasien TBC paru dengan DM tipe II. Galenical, 3(4), 111.
Evangelista, M. do S. N., Maia, R., Toledo, J. P., Abreu, R. G., & Barreira, D. (2020). Tuberculosis associated with diabetes mellitus by age group in Brazil. Brazilian Journal of Infectious Diseases, 24(2), 130–136.
Fadillah, N. A., Sulistiana, R., & Handayani, F. (2023). Comparison of chest X-ray of pulmonary TB patients with DM and non-DM. Jurnal Eduhealth, 14(1), 433–440.
Foe-Essomba, J. R., Kenmoe, S., Tchatchouang, S., Ebogo-Belobo, J. T., Mbaga, D. S., Kengne-Ndé, C., et al. (2021). Diabetes mellitus and tuberculosis, a systematic review and meta-analysis with sensitivity analysis for studies comparable for confounders. PLOS ONE, 16(12), e0261246. https://doi.org/10.1371/journal.pone.0261246
Hossain, M. J., Al‐Mamun, M., & Islam, M. R. (2024). Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Science Reports, 7(3), e2004.
Huang, L. K., Wang, H. H., Lai, Y. C., & Chang, S. C. (2017). Impact of glycemic status on radiological manifestations of pulmonary tuberculosis. PLOS ONE, 12(6), e0179750. https://doi.org/10.1371/journal.pone.0179750
Jeong, D., Mok, J., Jeon, D., et al. (2023). Prevalence and associated factors of diabetes mellitus among patients with tuberculosis in South Korea. BMJ Open, 13(3), e069642.
Khanijau, R., Kukkar, M. R., Trehan, E., & Singh, P. (2026). Global Trends and Burden of Diabetes Mellitus (DM): A Comprehensive Review of Epidemiology, Risk Factors, Health Disparities, and Future Projections. Journal of Drug Delivery & Therapeutics, 16(5), 216.
Mood, N., Tamma, M. K., Darivemula, S. B., & Advanapu, S. K. K. (2021). Clinico-radiological profile of pulmonary tuberculosis with diabetes mellitus. International Journal of Medical Research & Health Sciences, 10(8), 27–36.
Nadhira, A., Lukito, A., Ayu, M. S., & Sumedi, A. (2025). Analisis faktor risiko pada pasien tuberkulosis paru di Rumah Sakit Haji Medan tahun 2023. BEST Journal (Biology Education, Sains and Technology), 8(2), 799–805. https://doi.org/10.30743/best.v8i2.12113
Subkhan, M., Rezacharawa, M. A., Putra, M. A., Laitupa, A. A., Permana, P. B. D., & Irfana, L. (2024). Differences in chest X-ray imaging in pulmonary tuberculosis across various comorbidities. Magna Medika: Berkala Ilmiah Kedokteran dan Kesehatan, 11(2), 169–180. https://doi.org/10.26714/magnamed.11.2.2024.169-180
Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B. B., Stein, C., Basit, A., Chan, J. C. N., Mbanya, J. C., Pavkov, M. E., Ramachandaran, A., Wild, S. H., James, S., Herman, W. H., Zhang, P., Bommer, C., Kuo, S., Boyko, E. J., & Magliano, D. J. (2022). IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Research and Clinical Practice, 183, 109119. https://doi.org/10.1016/j.diabres.2021.109119
Tampubolon, P. Y., Rondo, A. G. E. Y., & Simanjuntak, M. L. (2022). Gambaran foto toraks pasien tuberkulosis paru dengan diabetes melitus di RSUP Prof. Dr. R. D. Kandou periode Januari–Juni 2022. Medical Scope Journal, 4(1), 72–78.
Van’t Hoog, A., Viney, K., Biermann, O., Yang, B., Leeflang, M. M. G., & Langendam, M. W. (2022). Symptom- and chest-radiography screening for active pulmonary tuberculosis in HIV-negative adults and adults with unknown HIV status. Cochrane Database of Systematic Reviews, 2022(3), CD010890. https://doi.org/10.1002/14651858.CD010890.pub2
Wahidin, M., Achadi, A., Besral, B., Kosen, S., Nadjib, M., Nurwahyuni, A., et al. (2024). Projection of diabetes morbidity and mortality till 2045 in Indonesia based on risk factors and NCD prevention and control programs. Scientific Reports, 14(1), 5424. https://doi.org/10.1038/s41598-024-54563-2
Wang, M., Cheng, G., Lu, Z., et al. (2015). Imaging manifestations of caseous pulmonary tuberculosis with type II diabetes mellitus. Radiology of Infectious Diseases, 2(3), 117–122.
Wilkinson, R. J. (2021). Tuberculosis and type 2 diabetes mellitus: An inflammatory danger signal in the time of coronavirus disease 2019. Clinical Infectious Diseases, 72(1), 79–81. https://academic.oup.com/cid/article/72/1/79/5857156
Workneh, M. H., Bjune, G. A., & Yimer, S. A. (2017). Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review. PLOS ONE, 12(4), e0175925. https://doi.org/10.1371/journal.pone.0175925
World Health Organization. (2024). Global tuberculosis report 2024. World Health Organization. https://www.who.int/publications/i/item/9789240101531
Yang, Q., Zhang, R., Gao, Y., et al. (2023). Computed tomography findings in patients with pulmonary tuberculosis and diabetes. BMC Infectious Diseases, 23, 436.
Zhan, S., Juan, X., Ren, T., Wang, Y., Fu, L., Deng, G., & Zhang, P. (2022). Extensive radiological manifestation in patients with diabetes and pulmonary tuberculosis: A cross-sectional study. Therapeutics and Clinical Risk Management, 18, 595–602. https://doi.org/10.2147/TCRM.S363328
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Rima Iska Marito Marbun, Pandiaman Pandia, Aida Aida, Yuki Yunanda
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under aCreative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
