For a long time, India has struggled with two main epidemics: type 2 diabetes (diabetes mellitus, DM) and tuberculosis (TB). With 74.2 million diabetics and 2.6 million new tuberculosis cases each year, it is critical to grasp the intricate relationship between these diseases.
The Big Idea
- Diabetic and tuberculosis (TB) are inextricably linked in India, with DM increasing the probability and severity of TB and TB co-infection affecting diabetic outcomes. Diabetes was found to be prevalent in 25.3% of persons with tuberculosis, whereas 24.5% were pre-diabetic. This underscores the importance of taking immediate action to address this dual burden and enhance care coordination for people impacted by both diseases.
What exactly is type 2 diabetes?
- Diabetes mellitus (DM), often known as type 2 diabetes, is a chronic metabolic condition characterised by elevated blood sugar levels.
- It is the most prevalent type of diabetes and usually develops gradually, usually in maturity.
- Type 2 diabetes occurs when the body either grows resistant to the effects of insulin (a hormone that helps regulate blood sugar levels) or produces insufficient insulin to maintain normal glucose levels.
What exactly is tuberculosis (TB)?
- Mycobacterium tuberculosis causes tuberculosis, an infectious disease.
- It primarily affects the lungs, but it can also affect other organs such as the kidneys, spine, and brain.
- When an infected person coughs, sneezes, or speaks, tiny droplets containing the bacteria are released into the air. These droplets, if inhaled by others, can cause illness.
The Relationship Between Diabetes and Tuberculosis
Increased TB chance:
- People with diabetes have a higher chance of contracting TB than those who do not have diabetes. Diabetes lowers the immune system and hinders the body’s ability to fight infections such as tuberculosis.
Increased TB Severity:
- When people with diabetes get TB, they have a greater bacterial load, which means they have more TB bacteria in their systems. This can lead to more severe symptoms and complications from tuberculosis.
Delayed Sputum Conversion:
- Sputum conversion refers to the change from having detectable TB bacteria in the sputum (positive) to not having detectable bacteria (negative) once treatment begins.
- Individuals with both TB and DM frequently have delayed sputum conversion as compared to those with only TB.
- It means that the TB bacteria take longer to be cleared from their systems, extending the infectious period and perhaps raising the risk of disease transmission to others.
Treatment Outcomes:
- The presence of diabetes can impact TB treatment outcomes. Individuals with both TB and DM may have different TB symptoms, radiological findings, and lung function than those with just TB.
- Individuals with TB and DM have lower lung function even after completing TB treatment, according to studies.
- Respiratory problems: People who have both TB and diabetes are more likely to have TB-related respiratory problems. Respiratory problems are a significant cause of death in this population, emphasising the increased severity of TB in the presence of diabetes.
What steps should India take to fight the twin burden of diabetes and tuberculosis?
- Implement patient-centered care techniques that meet the unique requirements of people with TB and diabetes, as well as other comorbidities. Coordinated diagnosis and treatment, bidirectional screening, patient education, and support are all part of this.
- Holistic Treatment Plans: Develop holistic treatment plans to strengthen high-quality care for TB, diabetes, and associated comorbidities. Prioritise individual TB and diabetes programmes and guarantee their integration into healthcare services.
- Resilient Health Systems: Develop and scale up resilient and integrated health systems by increasing stakeholder commitment, developing strong policy direction, and mobilising more resources. These activities will aid in the development of effective anti-disease strategies.
- Data-Informed Decision Making: Improve the scientific literature on the connections between TB and diabetes to enable better decision-making. Access to extensive data and ongoing research will provide crucial insights for improving patient care and raising awareness of the consequences of these interrelated disorders.
@the end
Diabetes mellitus and TB coexist in India and require quick attention. We can successfully address the twin burden of DM and TB by implementing integrated care models, improving treatment outcomes, and strengthening health systems. Health professionals, policymakers, and communities must prioritise research, improve collaboration, and collaborate to improve the lives of individuals affected by these interconnected epidemics.
Source: https://www.thehindu.com/sci-tech/health/diabetes-mellitus-tuberculosis-twin-epidemics/article67039946.ece