Tuberculosis And Diabetes—A Marriage Made In Hell

Here’s something that every diabetic should know—cases with a combination of diabetes and tuberculosis are becoming more and more frequent.

About 15 lakh cases of tuberculosis are found in India, out of which one to two lakhs are dual cases of tuberculosis and diabetes. Although there’s a national policy in India stating that tuberculosis patients must be screened for diabetes, many cases go undetected due to poor policy implementation.

TB And Diabetes Go Hand in Hand

Diabetes attacks the immune system and is considered a secondary immune deficiency disorder. Apart from the damage to the immune system, diabetes also causes changes in lung alveoli and bronchial reactivity, leading to decreased lung diffusion capacity and recoil. 

All these changes put a diabetic at 2-5 times a higher risk of contracting TB.

Recent studies show that approximately 18% of people with lung TB have diabetes, with a greater prevalence observed in younger people—especially those with low body weight and Type 1 diabetes. 

Dr Sridevi Paladugu, Consultant Endocrinologist, Apollo Hospitals explains, "In the majority of cases (45%), diabetes is detected first followed by TB. In about 25% of the cases, TB is detected first followed by diabetes. In another 20%, both are detected simultaneously. It’s very important for a diabetic patient to have chest X-Rays taken every year, as it helps in the diagnosis TB quickly and easily.

Diabetics, Watch Out For These TB Indicators

- Abnormal weight loss

- Unexplained cough

- Low-grade fever

-  Loss of appetite

Simple Preventive Measures

- Effective control of diabetes

- Good nutritious diet

-  General Hygiene

- Proper ventilation of living spaces

-  Washing hands frequently, especially before meals

High-Risk Types

Patients with uncontrolled diabetes are most at risk and require regular monitoring of blood sugar levels.

Dr S Sunanda, Senior Consultant Pulmonologist and Sleep Specialist at Care Hospitals, says, "The treatment of tuberculosis is very aggressive. Drugs are given in multiple combinations. Adequate medication must be determined, according to body weight and other factors. For those who have diabetes together with tuberculosis, there’s a need for aggressive blood control.”

It’s also very important to counsel the patient to complete the full treatment, as incomplete treatment leads to Multi-Drug Resistant Tuberculosis, which is a serious challenge to deal with.