Diabetes and Tuberculosis

Abstract

The increase in type 2 diabetes mellitus (DM) patients in countries where tuberculosis (TB) is also endemic has led to the reemerging importance of DM as a risk factor for TB. DM causes a 3-fold increase in TB risk and a 2-fold increase in adverse TB treatment outcomes. Given the sheer numbers of DM patients worldwide, there are now more TB patients with TB-DM comorbidity than TB-HIV coinfection. There is an urgent need to implement strategies for TB prevention and control among the millions of DM patients exposed to Mycobacterium tuberculosis . This chapter summarizes the current epidemiological, clinical, and immunological knowledge on TB and DM and their clinical and public health implications. These include the underlying mechanisms for TB risk in DM patients and their clinical and sociodemographic characteristics that distinguish them from TB patients without DM. TB-DM comorbidity is posing a new challenge for integrating the short-term care for TB with the long-term care for DM, particularly in low- and middle-income countries.

An Inflammatory Story: Antibodies in Tuberculosis Comorbidities

“…Spanning back to 1947, a review of diabetes and Mtb co-infection reported that 50% of diabetics succumbed to pulmonary TB (10). In recent years the epidemic has grown, with the number of individuals with Diabetes-TB overtaking those with HIV-TB (14); which can be attributed in part, to the positive impacts that antiretroviral therapy is having on reducing TB-HIV co-infection (15). Moreover, a recent multi-country cohort study found that patients with Diabetes-TB had more severe TB disease compared to individuals without diabetes (16).…”

Radiological Pattern of Pulmonary Tuberculosis in Diabetics Visiting a Tertiary Care Hospital

“…This emphasises the need for studies reporting a thorough characterisation of DM and other host factors with multivariable analysis in order to reach reliable conclusions. [1] The first report of the association between DM and TB was documented by Avicenna (980-1027 AD) over one thousand years ago. Since that time, the relationship between diabetes mellitus (DM) and tuberculosis (TB), and the nature of their interaction with regards to comorbidity are largely suggested by numerous epidemiological studies.…”

Uncontrolled Type 1 Diabetes Mellitus With Tuberculoma in Inferior Lobe Left Lung and Bilateral Hydronephrosis in Child

“…Hyperglycemia may also compromise Mtb killing by affecting the microvasculature and reducing lung tissue perfusion for optimal immune surveillance. 7 In addition, Arce-Mendoza et al (2008) reported that DM also affects the expression of receptors like CD64, CD206 and RAGE in monocytes. 12 Other possible factors that may impact the host response in patients with DM are short-chain fatty acids (SCFAs).…”

“…6 A systematic review of 13 observational studies found that DM increases the risk of TB by three-fold. 7 Thus, patients with DM comorbidity may pose a greater challenge the control of TB. 8…”