Factors Associated with Tuberculosis-Diabetes Mellitus Comorbidity

Tuberculosis and type 2 diabetes mellitus often occur together, especially in developing countries, creating a significant public health challenge. This case-control study conducted in Bandung, Indonesia, sought to uncover which demographic and clinical factors are associated with TB-DM comorbidity and how this dual condition affects patients' quality of life. Through structured interviews with 45 TB patients (15 with DM, 30 without), the study uncovered that age and education are critical risk factors. Older individuals and those with only primary education were significantly more likely to suffer from TB-DM comorbidity.

Clinical severity of TB also played a major role. Patients experiencing four or more TB symptoms were much more likely to also have diabetes, indicating that disease severity might exacerbate the metabolic vulnerability or vice versa. In terms of health outcomes, TB patients with DM reported significantly poorer quality of life, particularly in physical health, mental well-being, and environmental factors like housing and access to care.

Interestingly, while BMI and occupation were explored as potential factors, they did not show significant associations. This might reflect cultural or regional differences in the role of nutrition and employment on health or could stem from the study's limited sample size. Regardless, the stark differences in quality of life domains—especially the physical domain—underscore the compounded burden of TB-DM on daily functioning and well-being.

Ultimately, this research underscores the need for integrated management strategies in primary care settings. By addressing modifiable risk factors such as educational outreach and early symptom monitoring, health systems can better manage and possibly prevent this comorbid condition. Moreover, providing robust social and environmental support could mitigate the severe drop in quality of life faced by TB-DM patients.

Source: Nugrahaeni, D.K., Kusumasari, I., Budiana, T.A., and Mauliku, N.E. (2025). Factors Associated with Tuberculosis-Diabetes Mellitus Comorbidity. Periodic Epidemiology Journal/Jurnal Berkala Epidemiologi, 13(1):75-84.