Association of diabetes and tuberculosis--a major public health challenge

The burden of tuberculosis and diabetes is remarkably high in India. There is an increased risk for diabetic subjects to have active form of tuberculosis compared to their normal counterparts. The chance of reactivation of past tuberculosis infection is also common among the people with diabetes. In addition to that, few studies had reported that proportion of poor tuberculosis treatment outcomes such as treatment failure and death was higher in people with both tuberculosis and diabetes. A recent report from Tamil Nadu showed a very high prevalence of diabetes and prediabetes among tuberculosis patients. These findings strongly suggest the need of universal screening for diabetes among tuberculosis patients. There are several questions to be answered to assist in the formulation of strategies to address this dual burden in developing countries like India. The main purpose of the article is to summarise and discuss the available evidences and to define the area of future research to identify a cost-effective screening method for diabetes among tuberculosis patients and the best mode of reporting and managing the two diseases for the better control of tuberculosis and diabetes.