Impact of Type 2 Diabetes on Lung Damage and Outcomes in treatment-naïve pulmonary tuberculosis

Abstract Objective: To assess the impact of type 2 diabetes mellitus (T2DM) on risk and severity of structural lung disease (SLD) in treatment-naïve pulmonary tuberculosis (TB) patients, identify early predictors, and develop a prediction model for timely clinical intervention. Methods: We retrospectively studied 296 newly diagnosed pulmonary TB patients (201 males and 95 females; mean age 53.8 ± 18.0 years) between December 2021 and December 2024. Patients were categorized into SLD and non-SLD groups based on chest CT findings assessed using integrated visual CT scoring and quantitative image analysis. Baseline demographics, symptoms, and laboratory parameters were compared between groups. Multivariate logistic regression identified independent predictors of SLD; receiver operating characteristic (ROC) analysis evaluated the diagnostic performance of the clinical prediction model. Results: SLD patients were older, predominantly male, and had higher T2DM prevalence (P