review · International Journal of Infectious Diseases
The dual burden of tuberculosis and diabetes mellitus poses significant clinical and public health challenges globally. Diabetes increases an individual's susceptibility to tuberculosis and complicates its treatment, whilst active tuberculosis can worsen blood glucose control in diabetic patients. This bidirectional interaction contributes to poorer treatment outcomes across both conditions. Substantial obstacles persist in screening tuberculosis patients for diabetes and implementing tuberculosis preventive therapy among individuals living with diabetes. Available research into this comorbidity presents equivocal findings, which hinders effective disease prevention and management. Addressing this syndemic interaction requires urgent, integrated care approaches. An improved framework for prevention, screening, and combined disease management is necessary to control the underlying factors driving poor health outcomes in affected populations.
The coexistence of tuberculosis and diabetes creates a compound health burden that undermines disease management and treatment success. Understanding their mutual interaction is vital for healthcare systems to develop integrated diagnostic and treatment strategies, ensuring that patients with one condition are safely and effectively screened and treated for the other.
The proposed road map can assist public health programmes, clinicians, and healthcare planners in designing integrated prevention, screening, and treatment protocols. Because the findings outline strategic guidance and highlight equivocal clinical evidence rather than presenting a physical technology, practical application remains at the level of healthcare policy and clinical guideline development.
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The double burden of tuberculosis (TB) and diabetes mellitus (DM) represents a major public health challenge that demands urgent and integrated approaches. The interplay between these two chronic conditions presents unique clinical and public health management challenges, as well as social and economic implications. We explored the bidirectional relationship between TB and DM, emphasizing how DM increases susceptibility to TB and complicates its management, while TB may exacerbate glycemic control in diabetic patients. This review underscores the challenges associated with the management of both diseases, obstacles in screening TB patients for DM and TB preventive therapy for DM since inadequate glycemic control can impact treatment outcomes. Several studies have investigated the disease interplay; however, the results have been equivocal, and this may be exerting negative impacts on the disease prevention and treatment. TB-diabetes comorbidity has been linked to poor treatment outcomes whereas TB prevention in people with DM at present is a dilemma. In addition to highlighting how urgent it is to address this comorbidity, this review offers a road map for better prevention, treatment, and control of several factors underlying the TB-diabetes syndemic interaction.
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DOI: 10.1016/j.ijid.2024.107140
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