Objective To understand the characteristics of pulmonary tuberculosis (TB) patients complicated with diabetes and related factors in Shaanxi province from 2017 to 2024, and provide evidence for the development of targeted TB prevention and control strategies.

Methods The information about the sociodemographic characteristics (including sex, ethnicity, age, occupation, and household registration type) and clinical characteristics (including case detection source, bacteriological diagnosis results, treatment classification, and sputum smear results at 2 months) of the TB patients complicated with diabetes in Shaanxi between January 1, 2017 to December 31, 2024 were collected from the the Infectious Disease Surveillance Subsystem of China Disease Prevention and Control Information System. Statistical analysis was performed by using SPSS 25.0 and χ² test was used for univariate analysis on influencing factors, then binary Logistic regression analysis was conducted to identify independent risk factors.

Results From 2017 to 2024, a total of 140 851 pulmonary TB cases were registered in Shaanxi, in which 4 124 were complicated with diabetes, accounting for 2.93% of all the pulmonary TB cases (4 124/140 851). The annual registration rate of pulmonary TB cases complicated with diabetes increased from 0.61/100 000 in 2017 to 2.29/100 000 in 2024 (χ²=1925.832, P=＜0.001), with an average annual registration rate of 1.32/100 000. Multivariate Logistic regression analysis revealed that being man, age 30-60 years and >60 years, occupation (the retired, jobless unemployed), local household registration, detection through active screening or health check-up, being positive in bacteriological detection, retreatment, and having positive or unknown sputum smear results 2 months later were associated with higher likelihood of pulmonary TB complicated with diabetes.

Conclusions The annual registration rate of pulmonary TB cases complicated with diabetes increased in Shaanxi from 2017 to 2024, indicating the importance of strengthened disease diagnosis and management in this population. Middle-aged and elderly men, retirees, the unemployed, local residents, bacteriologically positive cases, and retreated cases should be prioritized in the prevention and control of pulmonary TB complicated with diabetes, with emphasis on early detection through active screening and health checkup. Patients with positive or unknown sputum smear results at 2 months have higher risk for pulmonary TB and diabetes comorbidity, warranting intensified bacteriological monitoring and management in treatment.