Diabetes may worsen TB, increase risk of death due to the condition: Experts

Diabetes continually weakens the immune system leading to poor health and a high risk of death among patients with tuberculosis TB said experts on TuesdayThe link between TB and diabetes two critical challenges to global health has long been established TB and diabetes both separately and combined significantly affect individuals communities and healthcare systems worldwideIndias TB burden remains a major public health challenge with 28 lakh TB cases accounting for 26 per cent the highest globally in 2024 The country also reported an estimated 315 lakh TBrelated deaths accounting for 29 per cent of the deaths globallyThe burden of diabetes is also consistently increasing in the country with over 100 million people currently living with the diseaseldquoDiabetes weakens the immune system increasing the risk of TB Diabetes further compromises the already weakened immune system of people who have TB leading to poor blood sugar control a higher likelihood of treatment failure and an increased risk of death during TB treatment when compared to those without diabetesrdquo Hemant D Shewade senior medical scientist at ICMRNational Institute of Epidemiology Chennai told IANSA recent paper published in the journal PLOS One led by Shewade and team noted that people with TB and diabetes are two to three times more likely to remain culturepositive four times more likely to experience a relapse after completing treatment and five times more likely to die compared to those without diabetesThe TB treatment also complicates the management of glucose levels thus diminishing the effectiveness of the disease managementShewade highlighted the need to improve documentation of monitoring glycemic status among people with TB and diabetes especially those notified by the national TB programmeCurrently under the programme guidelines the management of diabetes is the same for those with TB and those without TBBut ldquomore evidence is needed on whether one should target strict glycemic control HbA1C below 7 per cent or glycemic control that is not strict HbA1C below 8 per cent is sufficient More evidence is needed on whether insulin should be added for all people with TBdiabetes irrespective of the glycemic control statusrdquo the senior scientist told IANSIn addition the paper also suggested the capillary fasting blood glucose cFBG test to assess the glycemic status of a person with TBDMFurther studies have shown a 3550fold higher risk of TB in diabetes patients which is especially high in those with type 1 diabetesThese patients also have high relapse rates after antitubercular drugs and high mortality in case of delayed diagnosis The World Health Organization WHO recommends that patients with diabetes and a cough of more than two weeks need further evaluation for the possibility of TBldquoThere is limited information on the prevalence of pulmonary tuberculosis PTB in patients with Type1diabetesrdquo Dr Urvashi Singh Department of Microbiology All India Institute of Medical Sciences New Delhi told IANSRecent research published in the journal Multidisciplinary Respiratory Medicine led by Singh along with Dr R Goswami and Dr Randeep Guleria and Dr Abhilash Nair assessed the prevalence of PTB in 151 patients with type1diabetes attending the outpatient clinic in a tertiarycare hospitalAbout 106 per cent of them showed sputum culture positivity especially in those with a past history of PTBldquoThus there is a high prevalence of PTB in patients with type 1 diabetes in India They need to be actively screened for PTB by sputum Mycobacterium tuberculosis to initiate early treatment and to prevent transmission in the communityrdquo Singh saidThis story has been sourced from a third party syndicated feed agencies Midday accepts no responsibility or liability for its dependability trustworthiness reliability and data of the text Midday managementmiddaycom reserves the sole right to alter delete or remove without notice the content in its absolute discretion for any reason whatsoever