Diabetes & TB

           The article that I read related TB to the recent increase in type 2 diabetes. According to an article that was published in The Lancet Diabetes and Endocrinology, this dramatic increase in type 2 diabetes in low to middle income countries could impede the progress that is being made to try to treat and eradicate TB. One of the interesting facts that I found was that already 15% of the adult TB cases around the world can be contributed to diabetes.

            Before reading this article, I never really put together an association between TB and diabetes. Some of the important things that I learned was that not only can diabetes increase the risk of developing TB, but it can also lead to a poor TB prognosis. Another interesting fact was that having TB could also tend to worsen glucose control in patients that already have diabetes. According to the article, there has been a 52% increase in diabetes prevalence within the past 3 years, and this has occurred in 22 of the highest TB troubled countries around the world. The authors of this article labeled this as a "double-disease burden" and mention that it will be especially hard to fight this TB pandemic with diabetes coming alongside of it.

            Dr. Reinout van Crevel from Radboud University Medical Center in the Netherlands stated, "People with diabetes have a three times greater risk of contracting TB than people without diabetes, are four times more likely to relapse following treatment for TB, and are at twice the risk of dying during treatment than those without diabetes". The even worse news is the fact that the number of people with diabetes is expected to rise by 21% within the next 20 years. This obviously projects the TB incidence to increase as well. Doctors are stressing the importance of not only trying to treat TB but also treating diabetes alongside of it.

            Some of the interventions or ideas that have come about from the International Diabetes Federation consist of things like screening for TB in people with diabetes and screening for diabetes in people with TB. It was also noted that numerous people who were screened for TB, who already had diabetes, were found to have undiagnosed TB. This also was the case for people who were screened for diabetes who already had TB. One of the important notes is that people with diabetes who have good glucose control are less likely to acquire TB.

            Although management can be difficult in developing countries, we can work to kill two birds with one stone with some of our intervention strategies. The International Diabetes Foundation stated that it was crucial to provide guided standard treatment, early detection strategies and an effective drug supply. The World Health Organization also mentioned that many people with both diseases are not diagnosed or are diagnosed too late. That is why early detection of one or both diseases can improve one's chances of living a healthy life. The World Health Organization, in collaboration with other partners such as the International Union Against TB and Lung Disease have created the Collaborative Framework for Care and Control of TB and Diabetes to try to increase awareness and intervention strategies for these two diseases.

Lönnroth, K. (2014). The Lancet Diabetes & Endocrinology: Global epidemic of diabetes threatens to jeopardise further progress in tuberculosis control. The Lancet.

Tuberculosis and Diabetes: Collaborative Framework for Care and Control of Tuberculosis and Diabetes. (2011, January 1). Retrieved September 17, 2014.

Diabetes and Tuberculosis. (2011, January 1). Retrieved September 17, 2014.