Diabetes and TB interlinked, say doctors

In more bad news for people diagnosed with diabetes, the lifestyle disease has now been linked to an increased incidence of tuberculosis (TB) in patients.

According to the government-run Revised National TB Control Programme (RNTCP), people with diabetes have a two-three times higher risk of TB compared to people without diabetes and about 10 percent of TB cases globally are linked to diabetes.

Diabetes, which is characterized by high levels of glucose in the blood and the inability of the body to regulate blood sugar levels, is an independent risk factor for all lower respiratory tract infections, doctors said.

“The link between diabetes and tuberculosis is a recent knowledge and the subject of much research. Studies show that diabetes can lead to TB and the reverse is also true,” Anoop Mishra, chairman Fortis Centre of Excellence for Diabetes Metabolic Diseases and Endocrinology (CDOC), told IANS.

People with diabetes who are diagnosed with TB, an infectious disease of the lungs, have a higher risk of death during TB treatment and of TB relapse after treatment is over.

“Diabetes is complicated by the presence of infectious diseases like TB,” Mishra added.

Doctors are, therefore, increasingly screening both diabetes and TB patients for the two diseases, he added.

The reason behind diabetes patients easily contracting TB is the low immunity in them that results in high chances of infection.

India has a high burden of both diabetes and tuberculosis. In India, there are nearly 50 million diabetics, according to the statistics of the International Diabetes Federation – a global advocate for the promotion of diabetes care, prevention and cure.

The federation had declared that India was emerging as the diabetes capital of the world.

India has approximately two to three million people infected with Tuberculosis.

According to Rajeev Chawla of the North Delhi Diabetes Centre: “Previously there was a link between diabetes and HIV, but now we can see a link between diabetes and TB. Diabetes and TB can be seen to co-exist in many cases.”

“If a patient develops diabetes, it can also lead to reactivation of his or her TB which has been cured earlier.

“Diabetics should avoid contact with TB patients and always keep their blood sugar levels under check,” Chawla told IANS.

Also, in a large proportion of people, diabetes as well as TB is not diagnosed or is diagnosed too late.

Diabetes can lengthen the time to sputum culture conversion and theoretically this could lead to the development of drug resistance in TB patients, the doctor added.

Experts say the incidence of diabetes is increasing worldwide, especially in developing countries where TB is most prevalent.

Therefore, the convergence of these two epidemics is most likely to occur in the places with the least amount of healthcare resources, the doctors added.

Mishra said diabetic patients should maintain their blood sugar level in the best possible manner, exercise regularly, have proper diets and ensure that they get enough of Vitamin D.

The symptoms of diabetes can vary from person to person and depend upon the levels of sugar in the blood.

People with diabetes often feel extremely thirsty and need to urinate often. In addition to extreme hunger and unexplained weight loss, diabetes causes fatigue, blurred vision and high blood pressure.