MANAGEMENT OF PULMONARY TUBERCULOSIS AND DIABETES MELLITUS IN A 48 YEARS OLD WOMAN WITH FAMILY MEDICINE APPROACH

Abstract

Tuberculosis (TB) remains a global health problem due to Mycobacterium tuberculosis infects one-third of the world population. The increase in cases of TB in patients with Diabetes Mellitus (DM) also occurred in Indonesia. Quite a lot of diabetic patients who had TB and it increased the morbidity and mortality of TB and DM. The principle of treatment of DM in TB or non-TB is no different. Good blood sugar control is the main thing and the most important to watch for the successful treatment of pulmonary tuberculosis in patients with DM. A housewive, 48 years old, have history of DM, with a chief complaint of cough continuously that does not go better since a year ago. Cough accompanied by phlegm white without blood. Patients feel weight decreased about 10 kilograms inthe last 1 year since the patient had a cough that would not go away. The patient has histoy of contact with a neighbor who died because of TB about 10 months ago. On pulmonary auscultation found any ronkhi (+) in both lung fields. The readings of chest radiographs obtained TB diffuse, normal cast. Laboratory results with the results of sputum smear positive (+), when blood sugar levels 305mg/dl. Patients diagnosed pulmonary TB with DM. The patient lived with her husband and two children patients. Good relationships between family members, family problem-solving discussions. Hygiene of the patient's home environment is still not good. Clinical management in form of RHZE combination pills, Glibenclamide 1x5mg and Metformin 2x500mg and psychosocial management in the form of counseling and risk assessment. External factors most responsible is the patient has a history of contact with a neighbor who died because of TB. Interventions that have done are clinical management about provision of Anti-Tuberculosis Drugs and the Anti-Diabetic Drugs and psychosocial management to conduct a risk
assessment of the patient's family. [J Agromed Unila 2014; 1(2):132-138]
Keywords: diabetes mellitus, family medicine, tuberculosis, women