The present report describes the coincidence of pulmonary tuberculosis (TB) and metabolic disorder such as diabetes. A patient's bronchoalveolar lavage was found to be positive for acid-fast bacilli (AFB) with following growth of Mycobacterium tuberculosis and complete sensitivity to first line anti-TB drugs. At the same time, the patient presented with typical diabetes manifestation and subsequently required insulin therapy. Combined treatment resulted in significant clinical improvement and gradual resolution of both TB and diabetes symptoms. Therefore, we would like to highlight the value of appropriate medical management of these disorders sharing at least some clinical symptoms and signs such as weight loss and fatigue. Moreover, a growing body of evidence indicates that diabetes may play a role as a risk factor for TB. Consequently, the increasing diabetes prevalence may be a danger to TB control.