In recent times, India has been grappling with two severe health crises: Diabetes Mellitus (DM) and Tuberculosis (TB). With approximately 74.2 million Indians living with diabetes and 2.6 million afflicted with TB yearly, the country shoulders a significant healthcare burden. The seriousness of these individual epidemics is further complicated by their interrelation, making the challenge ever more complex.
The Interplay Between Diabetes and Tuberculosis
Diabetes significantly elevates the risk of various respiratory infections, particularly TB. In a study conducted in Chennai’s tuberculosis units in 2012, among TB patients, 25.3% also had diabetes, while 24.5% were pre-diabetic. This linkage poses more significant threats and risks, categorized into three main subheadings:
1- Increased Risk and Severity of Tuberculosis
Diabetes substantially increases the susceptibility to TB and exacerbates its severity. A diabetic individual’s impaired cell-mediated immunity weakens the body’s infection-fighting capabilities, including against TB.
2- Hampered Tuberculosis Recovery
DM complicates the recovery process from TB and extends the period required for the bacterium’s elimination from the body.
3- Altered Defense Mechanisms
Uncontrolled diabetes modifies the defense mechanisms in the lungs, making individuals more prone to TB infection. Furthermore, the altered functions of small lung blood vessels, coupled with poor nutritional status commonly ensuing from DM, create a conducive environment for TB bacteria invasion and establishment.
Impact of Coexisting Diabetes and Tuberculosis
Coexistence of TB and diabetes can lead to unfavorable TB treatment outcomes, such as treatment failure, relapse, re-infection, and death. The dual affliction may also modify TB symptoms, radiological findings, final outcomes, and prognosis, imposing a significant burden on individuals, healthcare systems, families, and communities.
Addressing the Dual Threat of Diabetes and Tuberculosis
Tackling this dual threat necessitates strategized efforts. Integrated treatment, patient education enhancement, support and nutrition development, and resilient health system establishment are critical. Furthermore, evidence-based decision-making, informed by thorough research, is essential in strengthening TB and DM healthcare programs.
About Diabetes Mellitus (DM)
DM is a disorder where the body inadequately produces or responds to insulin, leading to abnormally high blood glucose levels. Depending on its type, it either results from the immune system attacking the insulin-producing pancreas cells (Type 1 Diabetes) or the body developing an insulin resistance (Type 2 Diabetes), the latter predominantly seen in individuals older than 30.
About Tuberculosis (TB)
TB is an infectious disease caused by Mycobacterium tuberculosis mainly affecting the lungs but can infect other body organs. It has three stages: Primary infection, latent TB infection, and active TB disease.
Substantial efforts, both at individual and system levels, are required to tackle the interrelated epidemics of TB and diabetes. With adequate attention and comprehensive strategies, it is hoped that these dual health threats can be effectively mitigated.