Dr P S Sarma, CNS Correspondent, India
Diabetes Mellitus (DM) is one disease that can have an adverse affect on many organs of the body. Like wise, it has a great impact on all forms of TB—whether latent or active . People with DM have a high risk of getting TB, more so if they are having poor diabetes control. Diabetes prevalence is increasing especially is low income settings where TB is already endemic.
A first ever population based study of its kind done in the USA by Dr Leonardo Martinez, involving 4215 participants, found that TB prevalence in people with no diabetes was 4.1%, in those with pre diabetes it was 5.5% and in those with diabetes it was 7.6%. Overall tuberculosis prevalence in the entire sample was 5%. The study also found that diabetes (and pre-diabetes) increases risk of latent TB infection. Usually the risk for people with diabetes to get latent TB goes up two times but higher risk was found for those with poor glycaemic control.
There is enough evidence that DM and poorly managed DM increases risk of TB infection. Also, poor diabetic control enhances TB infection. Other reasons are tobacco smoking and consumption of alcohol. Socio economical determinants like poverty, malnutrition, etc also need to be addressed.
Cohort studies done in multi countries show that TB was more likely to increase in low and middle income countries when DM prevalence increased. For example, in India during 1998-2008 growing prevalence of DM increased the annual no of TB cases in diabetics by 46%.
DM increases the risk of active TB by about 3 fold. It also increases adverse TB treatment outcomes -i.e delayed sputum conversion, higher relapse rate and higher death rate. Drug –Drug interaction too can complicate TB treatment. In short undiagnosed, or inadequately treated and poorly controlled DM is a big threat to TB prevention and control .
WHO has given a collaborative frame work for care and control of TB & DM. All TB cases are to be tested for their blood sugar levels, and all people with diabetics with symptoms, like cough, need to be evaluated for TB.
Considering the effect of smoking on TB , it accounts for 80% of all TB cases world wide. In a study to gauge the effect of smoking on TB, it was observed that smoking more than 10 cigarettes per day was significantly associated with TB recurrence.
DM increases risk for progression from latent TB infection (LTBI) to active TB disease and complicates the treatment of active TB. Apart from TB, DM patients are also more susceptible to a range of infections, like urinary tract infections, skin & soft tissue infections, lung infections & foot infections.
TB, DM and smoking are the major health problems in our country and globally. 34.6% of adult population in India are tobacco users. People with TB who are smokers need to be counselled for smoking cessation. Uncontrolled DM affects the overall treatment outcomes for persons with active TB. So for optimum treatment outcomes DM must be controlled.
Close monitoring, proper care and management are essential to achieve good cure rates for TB.
Dr PS Sarma, Citizen News Service - CNS
3 November, 2017
A first ever population based study of its kind done in the USA by Dr Leonardo Martinez, involving 4215 participants, found that TB prevalence in people with no diabetes was 4.1%, in those with pre diabetes it was 5.5% and in those with diabetes it was 7.6%. Overall tuberculosis prevalence in the entire sample was 5%. The study also found that diabetes (and pre-diabetes) increases risk of latent TB infection. Usually the risk for people with diabetes to get latent TB goes up two times but higher risk was found for those with poor glycaemic control.
There is enough evidence that DM and poorly managed DM increases risk of TB infection. Also, poor diabetic control enhances TB infection. Other reasons are tobacco smoking and consumption of alcohol. Socio economical determinants like poverty, malnutrition, etc also need to be addressed.
Cohort studies done in multi countries show that TB was more likely to increase in low and middle income countries when DM prevalence increased. For example, in India during 1998-2008 growing prevalence of DM increased the annual no of TB cases in diabetics by 46%.
DM increases the risk of active TB by about 3 fold. It also increases adverse TB treatment outcomes -i.e delayed sputum conversion, higher relapse rate and higher death rate. Drug –Drug interaction too can complicate TB treatment. In short undiagnosed, or inadequately treated and poorly controlled DM is a big threat to TB prevention and control .
WHO has given a collaborative frame work for care and control of TB & DM. All TB cases are to be tested for their blood sugar levels, and all people with diabetics with symptoms, like cough, need to be evaluated for TB.
Considering the effect of smoking on TB , it accounts for 80% of all TB cases world wide. In a study to gauge the effect of smoking on TB, it was observed that smoking more than 10 cigarettes per day was significantly associated with TB recurrence.
DM increases risk for progression from latent TB infection (LTBI) to active TB disease and complicates the treatment of active TB. Apart from TB, DM patients are also more susceptible to a range of infections, like urinary tract infections, skin & soft tissue infections, lung infections & foot infections.
TB, DM and smoking are the major health problems in our country and globally. 34.6% of adult population in India are tobacco users. People with TB who are smokers need to be counselled for smoking cessation. Uncontrolled DM affects the overall treatment outcomes for persons with active TB. So for optimum treatment outcomes DM must be controlled.
Close monitoring, proper care and management are essential to achieve good cure rates for TB.
Dr PS Sarma, Citizen News Service - CNS
3 November, 2017
