People with diabetes are at a high risk of tuberculosis (TB). According to several studies and systematic reviews, people with diabetes might have 2 to 3 fold higher risk of getting tuberculosis (TB).
The linkage of TB and diabetes came out very prominently when different TB programme managers from Nepal, Thailand, India and those from different Indian states shared their experience at the recently concluded consultative workshop of the TB and poverty sub-working group of the Stop TB Partnership last October 29-30,2010.
The secretariat of TB and poverty sub-working group is housed in the South-East Asia office of the International Union Against Tuberculosis and Lung Disease (The Union) in New Delhi, India.
According to Dr Nevin Wilson, Regional Director of The Union’s South East Asia office that other important non-communicable disease (NCD) that will impact TB control in India and countries in the region is diabetes.The prevalence of this is where the general population is high.Early studies already suggest that about a fifth of incident sputum positive TB are co-morbid with diabetes. This will require coordinated and urgent measures. There is already a rural predominance in the distribution of diabetes in India. Together with TB, this combination will push poor people into greater poverty.
“The risk of mortality is much higher in TB patients who have co-existing diabetes. There are also evidences to suggest that when there is co-existing diabetes it takes longer for the sputum to become negative (for TB) with anti-tubercular treatment” said Dr Anil Kapur, President of the World Diabetes Foundation (WDF).
According to a research study done by the University of Texas School of Public Health Brownsville Regional Campus, people with type-II diabetes might be at greater risk for contracting TB. This study also further suggested that Type-II diabetes, especially type-II diabetes involving chronic high blood sugar, is associated with altered immune response to TB. TB.
“The other problem is that if in a family if somebody has diabetes, and another person in same family has TB, then the chance of the person with diabetes acquiring TB is high”,said Dr Kapur.
TB which predominantly occurs in social-economically less well-off people, people living in crowded places, in urban environments where they don’t have access to healthcare.What is starting to happen is that diabetes is much more often seen in people who are poor in the developing countries and also in countries where there is a high burden of TB” further.
Similarly people with diabetes who complain of persistent cough for more than two weeks, the doctors should be aware of the double risk for TB and diabete.Therefore it should be investigated these people for potential risk for TB.Such collaborative public health approach will yield positive public health outcomes.