Rapidly urbanizing nations are experiencing an increased threat of diabetes-related tuberculosis (TB). According to a study, “Improving Tuberculosis Prevention and Care through Addressing the Global Diabetes Epidemic: From Evidence to Policy and Practice,” published in The Lancet Diabetes & Endocrinology, patients with diabetes are at three-times higher risk of developing TB, with 15% of TB cases attributable to diabetes. A report from the World Health Organization (WHO) urges cities in India and China to address this crisis.
“Collaborative Framework for Care and Control of TB and Diabetes” outlines TB prevention, control, etiology, and complications; diabetes complications; diabetes mellitus prevention and control; health programs and plans; and guidelines from WHO and the International Union against TB and Lung Disease. The document is set to expire this coming year, but the risk of TB due to diabetes is no less threatening. “Changes in lifestyle and diet have contributed to an increased prevalence of diabetes in many low-income and middle-income countries where the burden of TB is already high,” wrote the authors of the document.
According to a news report from Times of India, the International Diabetes Federation, headquartered in Belgium, supports the WHO document and states, “TB is a major public health problem in many low- and middle-income countries, where the number of people with diabetes is rising rapidly. Regions such as Africa and Asia, which are worst affected by TB are also those that have the highest numbers of people with diabetes and will experience the biggest increases by 2030.”
Diabetes is a common co-morbidity in TB patients because diabetes is a metabolic disease that contributes to sustained infection with TB. Diabetic patients are more susceptible to infection, and infection can worsen glycaemic control, leading to a downward spiral. If the number of diabetes cases continues to rise, TB cases can be affected by 8% or more by 2035.
WHO provides advice for addressing these trends in its report. “Strategies are needed to ensure that optimal care is provided to patients,” the document stated. “TB must be diagnosed early in people with diabetes and vice versa.” Early diagnosis can bring help to affected individuals before either disease becomes unmanageable.