Title:Tuberculosis and Diabetes Mellitus Co-morbidity
Volume: 18
Issue: 4
Author(s): Degtyareva Svetlana*, Olga Vinokurova and Vera Zimina
Affiliation:
- Department of infectious diseases, Institute of Medicine, RUDN University, Moscow, Russian Federation
Keywords:
Tuberculosis, diabetes, epidemiology, clinical, prevention, public health.
Abstract: Tuberculosis (TB) and Diabetes Mellitus (DM) association poses the re-emerging
problem nowadays and challenge on the way towards a tuberculosis-free world. There are some peculiarities
in the immune function of DM patients, which make them more susceptible to infections,
including TB. This results in a higher prevalence of TB among DM patients (OR=1.15 according
to the last meta-analysis). Clinical manifestations of DM/TB often differ from the classical
course of the disease - these patients are more frequently symptomatic, more inclined to cavitary
disease and, according to some data, to lower lobe involvement. Data on multi-drug resistance prevalence
among DM/TB patients are controversial and need further research, especially in terms of
primary resistance. Higher frequency of adverse reactions, slower sputum conversion and foci regression
make treatment in this population more difficult and worsen outcomes. Potential measures
to lower the burden of co-morbidity are: new treatment regimens, bi-directional screening, proper
DM managing and controlling, testing for latent tuberculosis infection and its treatment, and new
vaccines development. Feasibility and efficacy of these measures are to be investigated in the context
of settings with different DM and TB prevalence and available resources.