Are diabetic patients prone to tuberculosis? Medical expert responds

Diabetes Mellitus (DM) increases the risk of TB disease two-to three-fold, according to recent studies and experts. This association may be even stronger in the presence of other risk factors, such as HIV infection or smoking. There is strong evidence that shows that an increased risk of tuberculosis occurs in both type 1 DM and type 2 DM.

In a conversation withWION, Dr Rahul Kendre, Consultant Lung Transplant Surgeon atDPU Private Super Speciality Hospital, said that DM is an important risk factor for Multi-Drug Resistant TB.

"Diabetes causes increased susceptibility to tuberculosis through several mechanisms, including hyperglycemia and cellular insulinopenia, which have indirect effects on macrophage and lymphocyte function and so our cell-mediated immunity is suppressed allowing flare up of latent tuberculosis into active tubercular disease,"Dr Rahul added.

Add WION as a Preferred Source

Further clarifying the connection between the two diseases, the medical expert continued, "TB per se does not cause DM although it may unmask those at risk of DM in the future. TB is associated with glucose intolerance and hyperglycaemia, both of which resolve automatically with TB treatment. In some studies, up to 50 per cent of TB patients who have high blood glucose levels at the time of diagnosis have normal levels by the end of TB treatment. TB also impairs glycaemic control among patients with previously known DM requiring higher insulin doses and oral hypoglycemic medications."

Approximately 15 per centof tuberculosis cases worldwide might be linked to DM. The reported prevalence of tuberculosis among DM patients ranges from 0.38 per cent to 14 per cent, and the overall median prevalence is reported to be 4.1 per cent.

One study of DM patients showed that the risk of active tuberculosis was three times greater among those with a haemoglobin A1c (HbA1c) level greater than or equal to 7 per cent than among those with an HbA1c level lesser than 7 per cent.

In addition, insulin dependence is purported to be a risk factor for tuberculosis. In the Philadelphia Diabetic Survey, the likelihood of developing tuberculosis was found to be twice as high among patients with DM using more than 40 units of insulin per day than among those using lower doses.

Symptoms of TB disease depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs (pulmonary TB).

TB disease in the lungs may cause symptoms such as a bad cough that lasts 3 weeks or longer, pain in the chest, and coughing up blood with sputum (phlegm from deep inside the lungs).

Other symptoms of TB include weakness or fatigue, loss of appetite, weight loss, low-grade fever in the evenings and sweating at night.

"Active TB disease may present atypically with altered symptoms and signs in those with DM and TB may progress faster for them. The effects of DM on chest radiograph findings are inconsistent. Some studies have described more frequent isolated lower lung field lesions and an increase in consolidation and cavities in Pulmonary TB in patients with DM, sometimes mimicking the pattern of radiographic TB seen in HIV,"Dr Rahul concluded.

Disclaimer: Please note that the information provided on this website is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition. The content provided on this website should not be used to diagnose or treat any health problem or disease. If you have or suspect that you have a medical problem, please contact your healthcare provider immediately. Never disregard professional medical advice or delay in seeking it because of something you have read on a website.

WATCH WION LIVE HERE

You can now write for wionews.com and be a part of the community. Share your stories and opinions with us here.