Vol. 8 No. 2 (2026): November 2026
Original Articles

Comparison of Blood Profiles between Drug-Resistant TB (DRTB) Patients with and without Diabetes Mellitus

Ririh Jatmi Wikandari
Poltekkes Kemenkes Semarang

Published 2026-10-01

Keywords

  • Tuberculosis,
  • Diabetes Mellitus,
  • Hematology Profile,
  • Comorbidity,
  • Inflammatory Biomarkers

How to Cite

Ririh Jatmi Wikandari, Umi Rosidah, & Qurrotu A’yuni Auliya. (2026). Comparison of Blood Profiles between Drug-Resistant TB (DRTB) Patients with and without Diabetes Mellitus. Jaringan Laboratorium Medis, 8(2), 83–91. https://doi.org/10.31983/jlm.v8i2.15266

Abstract

Diabetes mellitus (DM) is known to have a detrimental impact on the success of tuberculosis (TB) treatment, as it can increase the risk of therapy failure, disease recurrence, and even patient death. The presence of comorbid TB and DM makes the clinical management process more complex, increases the possibility of drug side effects, slows treatment response, and affects various patient hematological parameters. This study aims to compare the hematological profiles of Drug-Resistant Tuberculosis (DRTB) patients with DM and TB without DM. This study used a quantitative approach with a cross-sectional design. Data were obtained from Ario Wirawan Lung Hospital, Salatiga, covering the period from January to December 2025. The sample size was 54 patients, consisting of 27 TB with DM and 27 without DM. Laboratory test data were analyzed using SPSS version 25 software through a data normality test followed by an independent t-test. Respondent characteristics showed that TB patients were predominantly male (33 people) and female (21 people). The analysis results showed statistically significant differences in Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) parameters between the two groups. Furthermore, both TBRO groups with and without DM exhibited various hematological abnormalities, such as anemia, thrombocytosis, leukocytosis, and neutrophilia. These findings suggest that comorbid DM in TBRO patients contributes to differences in hematological profiles and triggers blood cell disorders.

 

References

  1. Abbas, U., Iqbal, K., Khan, A., Irfan, M., Saifullah, N., Jamil, B., & Hasan, Z. (2022). Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Tuberculosis and diabetes mellitus : Relating immune impact of co-morbidity with challenges in disease management in high burden countries. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 29(November), 100343. https://doi.org/10.1016/j.jctube.2022.100343
  2. Adewole, P. D., Ogundipe, T. D., Alabi, O. S., & Nuhu, A. (2024). Haematological Parameter among Drug Resistant Tuberculosis Patients in Ibadan. African Health Sciences, 24(1), 10–15. https://doi.org/10.4314/ahs.v24i1.3
  3. Al-Ofairi, B. A., Al-Jahrani, M. A., Esmail, A., Abdulkareem, A. M., & Saeed, M. K. (2026). Assessment of Some Hematological and Inflammatory Parameters among Patients with Active Pulmonary Tuberculosis in Ibb. BMC Infectious Diseases, 43, 1–15. https://doi.org/https://doi.org/10.1186/s12879-025-12261-y
  4. Asare, A. B., Asare, P., Yeboah-manu, M., Osei-wusu, S., Konadu, E. D., Asante-poku, A., Klinogo, Y., Adjei, A., Acheampong, D. O., Afriyie-mensah, J. S., Yacoba, A., & Yeboah-manu, D. (2026). Patients with tuberculosis and diabetes show altered clinical and biochemical parameters during anti-TB treatment. Nature Portofoliio, 16(7266), 1–15. https://doi.org/https://doi.org/10.1038/s41598-026-36529-8 1
  5. Bagus, I., Nugraha, A., Gotera, W., & Anggara, M. N. (2024). Review Article The Comparison of X-ray Finding in Pulmonary Tuberculosis with and without Diabetes Mellitus. InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes, 1(2), 88–95. https://doi.org/https://doi.org/10.66266/inajemd.v1i2.22
  6. Beshaw, M. A., Siraj, E. M., Demass, T. B., & Lakew, A. M. (2025). Severity and associated factors of anaemia among rifampicin/multi- drug- resistant tuberculosis patients treated in Alert and St . Peters specialised hospitals , Addis Ababa , Ethiopia : a retrospective cross- ­ sectional study. BMJ Open, 15, 1–9. https://doi.org/10.1136/bmjopen-2024-091111
  7. Bisht, M. K., Dahiya, P., Ghosh, S., & Mukhopadhyay, S. (2023). The cause – effect relation of tuberculosis on incidence of diabetes mellitus. Frontier Cell Infection Microbiology, June, 1–15. https://doi.org/10.3389/fcimb.2023.1134036
  8. Brake, J., Ajie, M., Sumpter, N. A., Ruslami, R., Hill, P., & Crevel, R. Van. (2025). Inflammation and dyslipidaemia in combined. IScience, 28(6), 112760. https://doi.org/10.1016/j.isci.2025.112760
  9. Dasaradhan, T., Koneti, J., Kalluru, R., & Gadde, S. (2022). Tuberculosis-Associated Anemia : A Narrative Review. Cureus, 14(8), 1–8. https://doi.org/10.7759/cureus.27746
  10. Ebrahim, H., Fiseha, T., Ebrahim, Y., & Bisetegn, H. (2022). Comparison of hematological parameters between type 2 diabetes mellitus patients and healthy controls at Dessie comprehensive specialized hospital , Northeast Ethiopia : Comparative cross-sectional study. Plos One, 17(7), 1–15. https://doi.org/10.1371/journal.pone.0272145
  11. Fadhilah, A. N., & Wikandari, R. J. (2024). The relationship between the length of treatment for pulmonary tuberculosis patients in the intensive phase and hemoglobin levels. Journal of Indonesian Medical Laboratory and Science, 5(2), 140–149. https://doi.org/10.53699/joimedlabs.v5i2.228
  12. Farzand, S., Rehman, S. T., Khan, M., Khokhar, A., Sarfraz, F., General, F. J., & Hospital, C. (2022). Assessment of Hematological Parameters in Tuberculosis Patients: An Analytical Study. Pakistan Journal of Chest Medicine, 28(02), 229–235. https://www.pjcm.net/index.php/pjcm/article/view/861
  13. Günlüoğlu, G., Veske, N. Ş., Bağcı, B. A., Aktepe, E. N., Pamir, P., Bolat, E., Seyhan, E. C., Ortaköylü, M. G., & Altın, S. (2026). Relationship between Disease Severity and Blood Cell Ratios in Tuberculosis. Haydarpasa Numune Medical Journal, 66(1), 58–64. https://doi.org/10.14744/hnhj.2025.87269
  14. He, X., Jiang, Y., Hou, H., & Wu, W. (2025). Inflammatory Markers as Predictors of Diabetes Mellitus in Patients with Pulmonary Tuberculosis : A Retrospective Analysis of Hematological Parameters and Clinical Features. Diabetes, Metabolic Syndrome and Obesity, 8(July), 2203–2212. https://doi.org/10.2147/DMSO.S523027
  15. Kementerian Kesehatan RI. (2025). Profil Kesehatan Indonesia 2024 (1st ed.). Kementerian Kesehatan Republik Indonesia. website: http://www.kemkes/go.id
  16. Kumar Koirala, P., Khandelwal, B., & A. Zaman, F. (2017). Study of Hematological Profile and Effect of Antitubercular Medications on the Hematological Derangements in Patients Suffering from Tuberculosis. Indian Journal of Emergency Medicine, 3(1), 45–50. https://doi.org/10.21088/ijem.2395.311x.3117.7
  17. Omair, M., Baig, M. S., Farooqui, W. A., Kousar, S., Noori, M. Y., Zeehan, N., Khan, A., Isa, S., Kamran, D. S., Bari, M. F., & Mehmood, M. (2024). Relationship of Neutrophil Lymphocyte Ratio, Monocyte Lymphocyte Ratio and Neutrophil Monocyte Ratio with Treatment Response in Pulmonary Tuberculosis Patients during Intensive Phase Treatment. BMC Infectious Diseases, 24(1), 1–7. https://doi.org/10.1186/s12879-024-09454-2
  18. Rathi, A., Patil, B. U., & Raut, A. (2023). Association of Tuberculosis With Diabetes and Anemia : A Hospital-based Cross-sectional Study from Central India. Medical Journal of Babylon, 20(1), 28–32. https://doi.org/10.4103/MJBL.MJBL
  19. Rosidah, U., Auliya, Q. A., Wikandari, R. J., & Widiyanto, S. D. (2024). Faktor Risiko Terjadinya Anemia pada Pasien Tuberculosis Paru dalam Fase Pengobatan Risk Factors for Anemia in Pulmonary Tuberculosis Patients in the Treatment Phase. Jaringan Laboratorium Medis, 06(02), 156–164. https://doi.org/https://doi.org/10.31983/jlm.v6i2.12268
  20. Shah, A. R., Desai, K. N., & Maru, A. M. (2022). Evaluation of hematological parameters in pulmonary tuberculosis patients. Journal of Family Medicine and Primary Care, 6(2), 169–170. https://doi.org/10.4103/jfmpc.jfmpc_2451_21
  21. Suryana, K. (2022). High Pretreatment Level of Neutrophil to Lymphocyte Ratio , Monocyte to Lymphocyte Ratio and Other Factors Associated with Delayed Sputum Conversion in Patients with Pulmonary High Pretreatment Level of Neutrophil to Lymphocyte Ratio , Monocyte to Lymphoc. Infection and Drud Resistance, 6973(15). https://doi.org/10.2147/IDR.S380166
  22. Wikandari, R. J., Surati, Nuryani, S., & Sistiyono. (2024). Hematological Profile of Pulmonary Tuberculosis Patients Before and After 1 Month of Taking Anti-TB Drugs. Jurnal Teknologi Laboratorium, 3(2), 135–144. https://doi.org/10.29238/teknolabjournal.v13i2.486
  23. World Health organization. (2022). Integrated care for tuberculosis (TB) and diabetes mellitus (DM) comorbidity in Asian countries: health system challenges and opportunities (Vol. 9, Issue 1). World Health Organization.
  24. World Health Organization. (2024a). Global Tuberculosis Report 2024 (first). World Health Organization. https://iris.who.int/bitstream/handle/10665/379339/9789240101531-eng.pdf?sequence=1
  25. World Health Organization. (2024b). Guideline on haemoglobin cutoffs to define anaemia in individuals and populations. https://www.who.int/publications/i/item/9789240088542
  26. World Health Organization. (2025). Global Tuberculosis Report 2025. World Health Organization. https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2025
  27. Xu, G., Hu, X., Lian, Y., & Li, X. (2023). Diabetes mellitus affects the treatment outcomes of drug-resistant tuberculosis : a systematic review and meta-analysis. BMC Infectious Diseases, 23(813), 1–13. https://doi.org/https://doi.org/10.1186/s12879-023-08765-0
  28. Zyada, K. M., Abdelwahab, A. E., Eid, H. A., & Madbouly, A. A. E.-. (2024). Complete blood count indices as inflammatory markers in diabetic patients with active pulmonary tuberculosis. Journal of Recent Advances in Medicine, 5(2), 111–120. https://doi.org/10.21608/jram.2024.287173.1243