Management of 63 Years Old Female Patient with Pulmonary Tuberculosis and Type 2 Diabetes Mellitus Through Family Medicine Approach in Susunan Baru Public Health Center


  • Desti Dwi Rahmah
  • Aila Karyus



Pulmonary tuberculosis, Type 2 Diabetes mellitus, Family medicine


Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which can attack the lungs and other organs. As many as 10.6 million people worldwide suffer from tuberculosis (TB) with an increase in the incidence rate of 3.6% between 2020 and 2021. Type 2 diabetes mellitus (DM) is one of the most important risk factors for worsening TB with a risk of active TB 2 -4 times higher in individuals with type 2 DM than non-DM. The study conducted in the form of a case report. Data were obtained through anamnesis, physical examination, laboratory examination, and medical records at PUSKESMAS. The assessment carried out based on the initial holistic diagnosis, process, and the final of the study both quantitatively and qualitatively. Based on the study, case a 63-year-old female patient with complaints of dry cough and phlegm for 2 months accompanied by an itchy throat, chills, decreased appetite and body weight. The patient has type 2 DM since 6 years. Family doctor services carried out to identify risk factors, clinical problems, as well as evidence-based medicine with patient management through a family approach, patient-centred, and community-oriented. Interventions done both medically and non-medically in the form of patient and family education about pulmonary tuberculosis and type 2 DM. Evaluation after the intervention obtained a decrease in fasting blood sugar, an increase in knowledge about the patient's disease, and an improvement in eating patterns.

Author Biographies

Desti Dwi Rahmah

Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Lampung

Aila Karyus




World Health Organzation. Global tuberculosis report 2022. Geneva: World Health Organization; 2022.

Kemenkes RI. Data dan Informasi Kementrian Kesehatan RI. Tuberkulosis. Jakarta: Infodatin Kemenkes RI. 2018

Hayashi S., Chandramohan D. Risk of active tuberculosis among people with diabetes mellitus: systematic review and meta-analysis. Tropical medicine & international health. TM & IH. 2018;23(10):1058–1070

Kuo MC, Lin SH, Lin CH, Mao IC, Chang SJ, Hsieh MC. Type 2 diabetes: an independent risk factor for tuberculosis: a nationwide population-based study. PLoS One. 2018;8(11):1-7

Jia Y, Hengfu C, Qiao L, Zhongqi L, Huan S, Dian X, dkk. Screening for pulmonary tuberculosis in high-risk groups of diabetic patients. Internasional journal of infectious disease. 2020;93: 84-89

Lamria P, Dian P, Teti T, Dina BL. Faktor-faktor yang mempengaruhi kejadian tuberkulosis pada umur 15 tahun ke atas di indonesia (analisis data survei prevalensi tuberkulosis (sptb) di indonesia 2013-2014). Puslitbang Upaya Kesehatan Masyarakat. 2020;23(1):10-17.

Krishna S, Jacob JJ. Diabetes Mellitus and Tuberculosis. [Updated 2021 Apr 18]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA):, Inc.; 2000-. Available from:

Anasulfalah H, Tamtomo DG, Murti B. Effect of Diabetes Mellitus Comorbidity and Mortality Risk in Tuberculosis Patientswho Received Tuberculosis Treatment: A Meta-Analysis. J Epidemiol Public Health. 2022;07(04): 441-453.

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

Sahril R, Yanri W S, Ari P. Identifikasi Faktor yang Mempengaruhi Keberhasilan Pengobatan Penderita Tuberkulosis di Kabupaten Bima 2014- 2016. Badan Penelitian dan Pengembangan Kesehatan. 2019;29(2): 171-176

Pascahana LP, Winarno, Tika DT. Faktor Yang Berhubungan dengan Keberhasilan Pengobatan Tuberkulosis Paru di Rumah Sakit Umum Karsa Husada Batu. Sport Science and Health. 2019; 1(1): 28-38

Kementerian Kesehatan RI. Penanggulangan Tuberkulosis. Peraturan Menteri Kesehatan Republik Indonesia Nomor 67 Tahun 2016. Jakarta: Kementerian Kesehatan RI; 2016

Yen FY, Chuang PH, Yen MY, Lin SY, Chuang P, Yuan MJ, et al. Association of Body Mass Index With Tuberculosis Mortality: A Population-Based Follow-Up Study. Medicine Journal. 2016; 95(1): 1-8.

Perhimpunan Dokter Paru Indonesia. Pedoman Diagnosis dan Penatalaksanaan Tuberkulosis di Indonesia. Jakarta: PDPI;2021.

Kementerian Kesehatan RI. Pedoman NAsional PelayananKedokteran Tatalaksana Tuberkulosis. Jakarta: Kementerian Kesehatan RI; 2020

Perkeni. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia Tahun 2021. Jakarta: Perkeni; 2021.

Frampton S, et al. Patient Centered Care Improvement Guide. Inc. and Picker Institute: 2008.

Kemenkes RI. Petunjuk Teknis Manajemen dan Tatalaksanan TB Anak. Jakarta: 2016.

Rajan SS, Misquith A, Rangareddy H. Calculated Glycosylated Hemoglobin (HbA1c) Compared with Estimated HbA1c by Nephelometry and Its Correlation to Estimated Average Blood Glucose (eAG). Galore International Journal of Health Sciences and Research ( 2020:Vol.5; Issue: 4.




How to Cite

Rahmah, D. D., & Karyus, A. (2023). Management of 63 Years Old Female Patient with Pulmonary Tuberculosis and Type 2 Diabetes Mellitus Through Family Medicine Approach in Susunan Baru Public Health Center. Medical Profession Journal of Lampung, 13(7), 1141-1151.




Most read articles by the same author(s)