The Effect of Diabetes

Mellitus On the
Successfully Tuberculosis
Treatment

Estiadah Tri Nurmastuti

NPM : 113219001
 Background
Indonesia is facing a
double burden of Tuberculosis
disease, there are The number of
communicable tuberculosis (TB)
diseases and non- cases according to
communicable Riskesdas data in
diseases. 2018 is 0.42% of the
total population.

Diabetes Melitus
the prevalence of
diabetes mellitus (DM) is
2% of the total population
in Indonesia.
Diabetes Mellitus disease has a
negative effect on clinical
conditions and treatment of
Tuberculosis disease. A person
with Diabetes mellitus is 2-3
times more susceptible to
being infected with
tuberculosis. The prevalence of
diabetes mellitus from the
tuberculosis cases is 12-17%
TB patients with complication of diabetes
mellitus
have risks, including:

Risk of causing treatment failure

Increased mortality from TB

Longer sputum conversion

The chance of relaps after treatment is

completed
 General Purpose
Explain the relationship
between diabetes mellitus and
tuberculosis
Problem Formulation
“Is there any effect of diabetes mellitus
with the success of tuberculosis Special Purpose
treatment?
Explaining the effect of
diabetes mellitus on the
success of tuberculosis
treatment.
 Literature Review
Tuberculosis Etiology
TB is caused by the People with poor
Mycobacterium immune conditions are
tuberculosis, which will more susceptible to
develop or spread when developing active TB
a person with TB disease disease than people with
expels the becteria into normal immune
the air, for example when systems. Such in cases
coughing of HIV, silicosis, diabetes
mellitus, and long term
use of corticosteroid.
(Kemenkes RI, 2019)
TB - DM
From various references, it is stated that
diabetes mellitus is one of the
comorbidities of tuberculosis. Based on
study conducted at North Sumatra, the
results showed that in patients with
elevated blood sugar levels with converted
by 8.2% of the total respondens. In the
category of decreased blood sugar levels with
converted BTA by 65.3% and non-converted
by 14.3%. It can be seen that the effect of
blood sugar levels on BTA conversion has a
significant relationship (Pulungan, 2020).
Literature Search
Strategy 1. Protocol and Registration, the
steps and evaluation of the
literature review use the PRISMA
checklist.

2. Framework Used PICOS is used as

a literature search strategy.

3. KeyWord, use keyword AND, OR

NOT or AND NOT were customized
by MeSH.

4. Database or searc engine, Journal

from Pubmed, Proquest, Science
direct, and SINTA.
 Criteria Inclusion Exclusion

National and international journals from

National and international journal
Population/ different databases related to research
from different databases and not
Problem variables namely TB-DM and TB
related with research variables
treatment
Literature Criteria
Other comorbidities are HIV,
There are comorbidities of Diabetes
Intervention pneumonia, kidney disorders,
Mellitus
heart disease

Comparation There is no comparation factor  

There is influence of
There is influence of comorbidities of
Outcome comorbidities of TB with cther
DM with the success of TB treatment
chronic disease

Cross sectional, cohort dan

Study design Systematic/Literature review, case There is no Exclusion factor
control, descriptive (case reports).

Publication of
Journals Published 2019 to 2021 Journal Published before 2021
year

Using other language from other

Language Indonesian and English
than the two languages using us
Literatur Selection (PRISMA)

Search literature through journal

publication databases and use
keywords that are adjusted to MeSH.
The results of the search for articles
will be screened and adjusted to the
theme of the literature review, namely
based on the feasibility of the
inclusion and exclusion criteria.
 Data Analysis
The assessment criteria were given a score of 'yes', Based on the inclusion criteria, there were 9
'no', 'unclear', or 'not applicable', and each studies related to diabetes mellitus and
criterion with a score of 'yes' was given one point tuberculosis treatment. Results
and another score was zero, each research score Characteristics of studies from 4 databases.
was then calculated and added up. Critical
appraisal to assess eligible studies, if the research
score at least 50% meets the critical appraisal
criteria with a cut-off point value that has been
agreed upon by the researcher, the study is
included in the inclusion criteria
 DISCUSSION

The relationship between tuberculosis and diabetes mellitus is very closely related. A person with DM
will be susceptible to TB disease, and conversely someone with TB disease is prone to having comorbid
DM. Diabetes mellitus comorbidity adversely affects the treatment of tuberculosis. DM disease causes
long sputum conversion that can trigger MDR-TB. Sputum conversion was influenced by the level of
sputum positivity at the start of treatment. The higher the positivity rate, the greater the risk of TB
treatment failure. However, the failure of TB-DM treatment can be prevented by taking anti-diabetic
drugs regularly. Normal blood sugar levels and controlled HbA1c levels can prevent TB treatment failure.
 CONCLUSION
Comorbid diabetes mellitus in TB patients
could lead to treatment failure, as well as
longer sputum conversion. So that TB-DM
patients must regularly take anti-diabetic drugs
such as metformin.
 SUGGESTION

Tuberculosis (TB) Infectious Disease Prevention Program

to screen blood sugar in TB patients. This is done as an
effort to prevent the occurrence of TB treatment failure,
TB relapse, or even resistant TB. At the same time to
reduce the number of TB cases in Indonesia.
THANK YOU…