Association Between 2-Hour Postprandial Blood Glucose Levels and Acid Fast Bacilli Positivity

https://doi.org/10.53770/medica.v8i5.1055

Authors

  • Azhari Muslim Department of Medical Laboratory Technology, Poltekkes Kemenkes Tanjungkarang, Bandar Lampung City, Lampung, Indonesia
  • Karbito Karbito Department of Environmental Health, Poltekkes Kemenkes Tanjungkarang, Bandar Lampung City, Lampung, Indonesia https://orcid.org/0000-0002-6424-099X
  • Hardono Hardono Master of Nursing Program, Universitas Aisyah Pringsewu, Pringsewu Regency, Lampung, Indonesia https://orcid.org/0000-0002-9962-4600

Keywords

Tuberculosis 2-Hour Postprandial Glucose Acid-Fast Bacilli

Abstract

Pulmonary tuberculosis (TB) and hyperglycemia have a bidirectional relationship, whereby impaired glucose metabolism can weaken cellular immunity and potentially increase the bacterial burden, resulting in a higher degree of acid-fast bacilli (AFB) positivity. Although the 2-hour postprandial blood glucose (2h-PPBG) test is a practical indicator of glucose intolerance, its association with AFB positivity in pulmonary TB patients remains inadequately explored. This study aimed to analyze the relationship between 2h-PPBG levels and the degree of AFB positivity among patients with pulmonary TB. A cross-sectional study was conducted at the Sukamaju Community Health Center in 2024 involving 60 adult patients (≥18 years) diagnosed with pulmonary TB and diabetes mellitus. Participants were selected based on confirmed pulmonary TB diagnosis and complete blood glucose records. Data were analyzed using Spearman’s correlation test and binary logistic regression. The results demonstrated a strong and statistically significant positive correlation between 2h-PPBG levels and the degree of AFB positivity. Logistic regression analysis indicated that every 10 mg/dL increase in 2h-PPBG was associated with a 9.3% increase in the odds of higher AFB positivity. In conclusion, elevated 2h-PPBG levels were significantly associated with greater AFB positivity among patients with pulmonary TB and diabetes mellitus. These findings highlight the importance of routine glycemic screening and optimal glucose control as part of comprehensive tuberculosis management to reduce disease severity and improve treatment outcomes.

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References

Bhargava, A., Bhargava, M., Meher, A., Teja, G. S., Velayutham, B., Watson, B., ... & Joshi, R. (2023). Nutritional support for adult patients with microbiologically confirmed pulmonary tuberculosis: outcomes in a programmatic cohort nested within the RATIONS trial in Jharkhand, India. The Lancet Global Health, 11(9), e1402-e1411. https://doi.org/10.1016/S2214-109X(23)00324-8

Boadu, A. A., Yeboah-Manu, M., Osei-Wusu, S., & Yeboah-Manu, D. (2024). Tuberculosis and diabetes mellitus: The complexity of the comorbid interactions. International journal of infectious diseases, 146, 107140. https://doi.org/10.1016/j.ijid.2024.107140

Byers, M., & Guy, E. (2024). The complex relationship between tuberculosis and hyperglycemia. Diagnostics, 14(22), 2539. https://doi.org/10.3390/diagnostics14222539

Chiang, C. Y., Bai, K. J., Lin, H. H., Chien, S. T., Lee, J. J., Enarson, D. A., ... & Yu, M. C. (2015). The influence of diabetes, glycemic control, and diabetes-related comorbidities on pulmonary tuberculosis. Plos one, 10(3), e0121698. https://doi.org/10.1186/s40249-026-01432-x

Chidambaram, V., Tun, N. L., Majella, M. G., Ruelas Castillo, J., Ayeh, S. K., Kumar, A., ... & Karakousis, P. C. (2021). Male sex is associated with worse microbiological and clinical outcomes following tuberculosis treatment: a retrospective cohort study, a systematic review of the literature, and meta-analysis. Clinical Infectious Diseases, 73(9), 1580-1588. https://doi.org/10.1093/cid/ciab527

Dwinata, I., Tsheten, T., Ansariadi, A., Wagnew, F., Alene, K. A., Sutarsa, I. N., ... & Kelly, M. (2026). Geospatial codistribution of tuberculosis and diabetes mellitus in Indonesia. Infectious Diseases of Poverty, 15(1), 37. https://doi.org/10.1186/s40249-026-01432-x.

El Nahas, R., Al-Aghbar, M. A., Herrero, L., van Panhuys, N., & Espino-Guarch, M. (2023). Applications of genome-editing technologies for type 1 diabetes. International Journal of Molecular Sciences, 25(1), 344. https://doi.org/10.3390/ijms25010344

Field, A. (2020). Discovering statistics using IBM SPSS statistics (5th ed.). SAGE Publications.

Jayashankar, C. A., Manjunath, B. M., Shalini, A. S., Harsha, A. M., & Shalini Jr, A. S. (2021). The association of pulmonary tuberculosis, abnormal glucose tolerance, and type 2 diabetes mellitus: a hospital-based cross-sectional study. Cureus, 13(11), 1-6. https://doi.org/10.7759/cureus.19758

Kreisel, C. F., Passannante, M. R., & Lardizabal, A. A. (2019). The negative clinical impact of diabetes on tuberculosis: a cross-sectional study in New Jersey. Journal of the Endocrine Society, 3(1), 62-68. https://doi.org/10.1210/js.2018-00203

Lampung Provincial Health Office. (2022). Health Profile of Lampung Province 2022. Lampung: Lampung Provincial Health Office.

Lampung Provincial Health Office. (2024). Health Profile of Lampung Province 2024. Lampung: Lampung Provincial Health Office.

Lin, Y., Harries, A.D., Kumar, A.M.V., Critchley, J.A., van Crevel, R., Owiti, P., Dlodlo, R.A. Dejgaard A. (2019). Management of diabetes mellitus-tuberculosis: a guide to the essential practice. Paris: International Union Against Tuberculosis and Lung Disease.

Meng, F., Lan, L., Wu, G., Ren, X., Yuan, X., Yang, M., Chen, Q., Peng, X., & Liu, D. (2023). Impact of diabetes itself and glycemic control status on tuberculosis. Frontiers in endocrinology, 14, 1250001. https://doi.org/10.3389/fendo.2023.1250001

Ministry of Health of the Republic of Indonesia. (2023). Technical guidelines for TB management and management (2nd Edition). Jakarta: Directorate General of Disease Prevention and Control.

Sahidan, S., Sulistyasmi, W., Farizal, J., Hartini, S., & Ujiani, S. (2026). The Role of Vitamin D in TNF-α Levels in Pulmonary TB Patients. MEDICA (International Medical Scientific Journal), 8(4), 152-159. https://doi.org/10.53770/medica.v8i4.908

Ssekamatte, P., Sande, O. J., Van Crevel, R., & Biraro, I. A. (2023). Immunologic, metabolic and genetic impact of diabetes on tuberculosis susceptibility. Frontiers in Immunology, 14, 1122255. https://doi.org/10.3389/fimmu.2023.1122255

World Health Organization. (2024). Global tuberculosis report 2024. Geneva: World Health Organization. Retrieved from https://www.who.int/publications/i/item/9789240101531

Wu, Q., Liu, Y., Ma, Y. B., Liu, K., & Chen, S. H. (2022). Incidence and prevalence of pulmonary tuberculosis among patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Annals of Medicine, 54(1), 1657-1666. https://doi.org/10.1080/07853890.2022.2085318

Ye, Z., Li, L., Yang, L., Zhuang, L., Aspatwar, A., Wang, L., & Gong, W. (2024). Impact of diabetes mellitus on tuberculosis prevention, diagnosis, and treatment from an immunologic perspective. Exploration, 4(5), 20230138. https://doi.org/10.1002.

Yorke, E., Boima, V., Dey, I. D., Amissah-Arthur, M. B., Ganu, V., Amaning-Kwarteng, E., Tetteh, J., & Charles Mate-Kole, C. (2021). Transient Impact of Dysglycemia on Sputum Conversion among Smear-Positive Tuberculosis Patients in a Tertiary Care Facility in Ghana. Clinical medicine insights. Circulatory, respiratory and pulmonary medicine, 15, 1-8. https://doi.org/10.1177/11795484211039830

Zahid, M., Afaq, S., Shafique, K., Qazi, F. K., Ashfaq, U., Asim, M., Nooreen, S., & Shehzad, S. (2025). Effect of glycemic control on tuberculosis treatment outcomes among patients with tuberculosis and diabetes mellitus: A systematic review and meta-analysis. Tropical medicine & international health, 30(8), 749–762. https://doi.org/10.1111/tmi.14140

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Published

2026-05-31

How to Cite

Muslim, A., Karbito, K., & Hardono, H. (2026). Association Between 2-Hour Postprandial Blood Glucose Levels and Acid Fast Bacilli Positivity. MEDICA (International Medical Scientific Journal), 8(5), 266–273. https://doi.org/10.53770/medica.v8i5.1055