Diabetes is a chronic disease that impairs the body’s ability to convert food into energy. In diabetes, either insulin is not produced properly or it is not used properly. TB is a disease caused by tuberculosis bacilli. The disease mainly affects the lungs (pulmonary TB), but germs can travel to other parts of the body (extrapulmonary TB) and sometimes to multiple parts of the body (military or transmitted TB).Also read – Studies have shown that the origin of diabetes can be different in men and women
The first report of a link between diabetes mellitus (DM) and tuberculosis (TB) was first reported by Avicenna (980-1027AD) 1000 years ago. The prevalence of diabetes affects the incidence of tuberculosis (TB) and TB mortality. It is associated with a two- to three-fold increased risk of tuberculosis, doubles the risk of death during TB treatment, quadruples the risk of recurrence of TB after treatment, and doubles the risk of multidrug-resistance. TB (MDR-TB). TB doubles the risk of diabetes mellitus. Diabetes may be associated with 15% of all TB cases worldwide. Also read – World TB Day 2022: Early Signs, Symptoms and Treatment, What You Need to Know, Expert Speaks – See
Once a patient is infected with TB bacilli, there are 4 possible consequences: Also read – Can Tuberculosis Lead to Skin Problems? Explains a dermatologist
- Immediate approval of bacilli
- Latent infection (LTBI)
- Onset of active disease (primary disease)
- Reactivation of the disease after many years.
Patients with latent TB infection and diabetes are more likely to develop active TB disease than non-diabetic patients.
DM favors the growth, efficacy and proliferation of tubercle bacilli and reduces resistance to infection and repair. Patients with tuberculosis have a higher rate of diabetes, as well as impaired glucose tolerance. Impaired glucose tolerance is an important risk factor for the development of DM. Part of the hyperglycemia associated with tuberculosis may be due to the extreme stress associated with the infection.
DM should be administered aggressively in TB patients. Optimal glycemic control results in better results; Therefore intensive efforts should be made to achieve such control. It is advisable to start insulin therapy from the beginning, insulin requirements are higher, initially, but decrease after a few weeks as the infection gets under control.
May interact with anti-tubercular diabetes drugs such as rifampicin and isoniazid, leading to fluctuations in blood sugar levels.
Both diseases are linked and need to be treated together to ensure good results. The WHO outlines activities in a collaborative framework for the care and control of TB and diabetes.
(Article written by Dr. Sneha Kothari, Consultant Endocrinologist, Global Hospital Parel, Mumbai)
