The Pattern and Behavior of Pulmonary Tuberculosis in Diabetic Patients

¹ Ein-Shams University Hospital

A review of 371 cases of bronchogenic tuberculosis in diabetics was made; all cases were treated by chemotherapy and observed for two years. Diabetes was either known to exist before tuberculosis or both diseases were discovered simultaneously. The pattern of tuberculosis lesions was not found to be characteristic of diabetes. No correlation was found between the duration of diabetes before tuberculosis or its severity and the pattern or behavior of the tuberculous lesion on treatment. Ketosis was an important factor affecting the response to chemotherapy. Oral hypoglycemic agents were found valuable in 56 cases whose course and end-result did not differ from comparable cases treated with insulin alone.

Strict adherence to regularity of chemotherapy is the most important factor bearing on the final outcome of these cases. Surgical intervention is safe in tuberculous diabetics if properly indicated and if done at the optimum time. The results at the end of two years were favorable (69 per cent arrested lesions) and the fatality rate was 6.5 per cent.