DOI: http://dx.doi.org/10.18203/2349-3933.ijam20180068

The double burden of tuberculosis and diabetes prevalance of diabetes melitus in tuberculosis

Rajesh Kumar Khare, Vivek Katiyar

Abstract


Background: The burden of diabetes mellitus is increasing worldwide. The prevalence of TB has been rising in recent years globally. Aging, changes in life style, socioeconomic factors, and population growth have lead to an increased prevalence of DM, particularly, type 2 DM. Diabetes Mellitus (DM) almost triples the risk of developing tuberculosis (TB). India, the nation with the highest number of TB cases in the world, is also undergoing epidemic growth in DM rates. With the demographic transition underway globally, increase in life expectancy, improvements in provision of health services and a subsequent increase in the elderly population, the absolute numbers of cases of diabetes will increase exponentially. As a result, DM and TB are increasingly present together, and this calls for renewed interest in this topic. Various studies done in different parts of India and in other parts of globe where TB is endemic have shown a higher prevalence of DM among PT infected with tuberculosis. We in our study undertaken in Department of medicine in IIMS&R Lucknow UP found a high prevalence of DM amongst TB patients. Routine screening of TB patients for DM will help detect cases of diabetes and pre-diabetes early, so that primary prevention methods may be initiated early and effectively.

Methods: This hospital-based cross-sectional study was undertaken in Department of medicine in IIMS and R Lucknow UP. All TB cases more than 18 years of age, including new and re-treatment cases, sputum positive, sputum negative and extra-pulmonary cases currently on treatment in the were included in the study.

Results: Using the diagnostic criteria, as mentioned in the methodology, the prevalence of diabetes among TB patients in this study was found to be 24.5% of which 18.5% were known DM cases and 5.9% were newly diagnosed.

Conclusions: The burden of diabetes mellitus is increasing worldwide. The association between diabetes and tuberculosis is the next challenge for global tuberculosis control. Improved understanding of the bidirectional relationship of the two diseases is necessary for proper planning and collaboration to reduce the dual burden of diabetes and TB. In people with TB, it may be appropriate to actively screen for DM. Prevention, screening, and treatment of both diseases together is more effective.

 


Keywords


Diabetes, Prevalence, Risk factors, Tuberculosis

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References


Corbett EL, Watt CJ, Walker N, Maher D, Williams BG, Raviglione MC, et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med. 2003;163(9):1009-21.

World Health Organization. WHO report 2010. Geneva, Switzerland: Global tuberculosis control, 2010. Available at http://apps.who.int/iris/bitstream /10665/44425/1/9789241564069_eng.pdf.

Harries AD, Lin Y, Satyanarayana S, Lonnroth K, Li L, Wilson N, et al. The looming epidemic of diabetes-associated tuberculosis: learning lessons from HIV-associated tuberculosis. Int J Tuberc Lung Dis. 2011;15(11):1436-44.

Harries AD, Dye C. Tuberculosis. Ann Trop Med Parasitol. 2006;100(5-6):415-31.

International Diabetes Federation. IDF diabetes atlas. 4th edition. Brussels, Belgium: International Diabetes Federation; 2009.

Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis. 2009;9(12):737-46.

Esteghamati A, Gouya MM, Abbasi M, Delavari A, Alikhani S, Alaedini F, et al. Prevalence of diabetes and impaired fasting glucose in the adult population of Iran: National survey of risk factors for non-communicable diseases of Iran. Diabetes Care. 2008;31(1):96-8.

Lonnroth K, Castro KG, Chakaya JM, Chauhan LS, Floyd K, Glaziou P, Raviglione MC. Tuberculosis control and elimination 2010-50: cure, care, and social development. Lancet. 2010;375(9728):1814-29.

Ruslami R, Aarnoutse RE, Alisjahbana B, van der Ven AJ, Van Crevel R. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop Med Int Health. 2010;15(11):1289-99.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53.

Goldhaber-Fiebert JD, Jeon CY, Cohen T, Murray MB. Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants. Int J Epidemiol. 2011;40(2):417-28.

Harries AD, Murray MB, Jeon CY, Ottmani SE, Lonnroth K, Barreto ML, et al. Defining the research agenda to reduce the joint burden of disease from diabetes mellitus and tuberculosis. Trop Med Int Health. 2010;15:659-63.

Sen T, Joshi SR, Udwadia ZF. Tuberculosis and diabetes mellitus: merging epidemics. J Assoc Physic Ind. 2009;57:399-404.

Ruslami R, Aarnoutse RE, Alisjahbana B, van der Ven AJ, Crevel RV. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop Med Int Health. 2010;15:1289-99.

Ramachandran A, Ma RCW, Snehalatha C. Diabetes in Asia. Lancet. 375;408-18.

Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2· 7 million participants. Lancet. 2011;378(9785):31-40.

International Diabetes Federation. IDF Diabetes Atlas. 5th ed. International Diabetes Federation, Brussels. 2011. Available at http://www. eatlas.idf.org. Accessed 20 July 2011.

TB India. Annual Status Report, RNTCP. CTD, MOH and FW, New Delhi. 2012. Available at tbcindia.nic.in/pdfs/TB%20India%202012-%20 Annual %20Report.pdf. Accessed August 7, 2013.

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125:217-30.

Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med. 2008;5:e152.

Stevenson CR, Critchley JA, Forouhi NG, Roglic G, Williams BG, et al. Diabetes and the risk of tuberculosis: a neglected threat to public health? Chronic Illn. 2007;3:228-45.

Ezung T, Devi NT, Singh NT, Singh TB. Pulmonary tuberculosis and diabetes mellitus-a study. J Indian Med Assoc. 2002;100:376.

Patel JC. Complications in 8793 cases of diabetes mellitus 14 years study in Bombay Hospital, Bombay, India. Ind J Med Sci. 1989;43(7):177-83.

Federation ID. IDF diabetes atlas: International Diabetes Federation. Executive Office. 2011. Available: http://www.eatlas.idf.org. Accessed December 25, 2011.

Ramachandran A, Das AK, Joshi SR, Yajnik CS, Shah S, Kumar KP. Current status of diabetes in India and need for novel therapeutic agents. J Assoc Physicians Ind. 2010;58:7-9.

Stevenson CR, Forouhi NG, Roglic G, Williams BG, Lauer JA, et al. Diabetes and tuberculosis: the impact of the diabetes epidemic on tuberculosis incidence. BMC Public Health. 2007;7:234.

Central TB Division. Screening of tuberculosis patients for diabetes mellitus: pilot project, module for RNTCP staff. MOH and FW, New Delhi, 2009.

Singla R, Khan N, Al-Sharif N, Al-Sayegh MO, Shaikh MA, Osman MM. Influence of diabetes on manifestations and treatment outcome of pulmonary TB patients. Int J Tuberc Lung Dis. 2006;10:74-9.

Li L, Lin Y, Mi F, Tan S, Liang B, Guo C, et al. Screening of patients with tuberculosis for diabetes mellitus in China. Trop Med Int Health. 2012;17:1294-301.

Alisjahbana B, Sahiratmadja E, Nelwan EJ, Purwa AM, Ahmad Y, Ottenhoff TH, et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis. 2007;45:428-35.

Jain MK, Baghel PK, Agrawal R. Study of impaired glucose tolerance in pulmonary tuberculosis. Indian J Community Med. 2006;31(3):137-9.

Chang JT, Dou HY, Yen CL, Wu YH, Huang RM, Lin HJ, et al. Effect of type 2 diabetes mellitus on clinical severity and treatment outcome in patients with pulmonary tuberculosis: A potential role in the emergence of multi-drug resistance. J Formos Med Assoc. 2011;110:372-81.

Guptan A, Shah A. Tuberculosis and diabetes: an appraisal. Ind J Tub. 2000;47(3):2-8.

Ponce-De-Leon A, Garcia-Garcia Md Mde L, Garcia-Sancho MC, Gomez-Perez FJ, Valdespino-Gomez JL, et al. Tuberculosis and diabetes in southern Mexico. Diabetes Care. 2004;27:1584-90.