The efforts to control tuberculosis (TB) could be compromised if the rates of type 2 diabetes don’t cease to increase in low and middle-income countries, suggests a three-part Series about the two diseases published in The Lancet Diabetes & Endocrinology and quoted a recent press release.
Diabetes increases the risk of developing TB and by now, according to the Series, 15% of TB diagnostics in adults may be related to diabetes.
The number corresponds to more than a million people a year who suffer from diabetes-associated TB, most of which (40%) are living in India and China, the top two countries with the highest estimated number of adult TB cases. In the third place is South Africa, followed by Indonesia and Pakistan.
Researchers also estimated that the 52% increase in diabetes prevalence between 2010 and 2013 may be related to a rise from 10% to 15% (2013) in diabetes-associated TB cases.
The relationship between diabetes and TB is mutual, meaning that if diabetes increases the risk of TB, TB also affects patients with diabetes, worsening their glucose control.
These are some of the factors and observations that led the research team to believe that “TB control is being undermined by the growing number of people with diabetes, which is expected to reach an astounding 592 million worldwide by 2035,” according to Dr Knut Lönnroth from the Global TB Programme at WHO in Geneva.
Dr. Reinout van Crevel, Series co-author and infectious disease specialist at Radboud University Medical Center in the Netherlands, also added that the risk for people with diabetes to contract TB is three times higher than for healthy people, and they’re also “four times more likely to relapse following treatment and are twice the risk of dying” while on treatment.
The International Diabetes Federation (IDF) points to a growing diabetes rate over the next 20 years (21%), meaning that more than 10% of adults will suffer from the disease. Linked to these numbers may be a tuberculosis incidence of 3% higher than the anticipated one.
But this perspective can be averted, according to the authors, with public health focused on prevention and improvement care for diabetes. Researchers warn that to “achieve post-2015 global TB target to reduce TB incidence by 90%, increased efforts (…) will be crucial,” said Lönroth.