What’s the link? Diabetes, latent TB, active TB disease and drug resistant TB

This population-based study of 4215 individuals in the United States tested for latent TB infection and several biomarker tests for diabetes. This included 776 people with diabetes, 1441 people with pre-diabetes condition, and 1998 people without diabetes. The study shows that people with diabetes had higher rates of latent TB infection than those who did not have diabetes. Prevalence of latent TB infection was 4.1% in people without diabetes, 5.5% in people with pre-diabetes condition, and 7.6% in people with diabetes. Alarmingly, it also showed that people with diabetes, with poor glycemic control (or diabetes control) were even more likely to have latent TB infection.

For example, people with undiagnosed diabetes (who often have uncontrolled diabetes) had 12 percent prevalence of latent TB infection; a rate 3-4 times higher than the general population. People with diabetes with high levels of fasting plasma glucose, a biomarker of poor glycemic control also had significantly higher rates of latent TB infection.

Diabetes TB collaborative activities are vital

Governments of over 190 nations globally have committed to end TB by 2030 and reduce untimely deaths due to diabetes and other non-communicable diseases (NCDs) by one-third by 2030. If we are to end TB, we cannot ignore the mountainous reservoir of latent TB infection in our population. Experts estimate that in high burden nations like India, up to one-third of the population might have latent TB infection. In this reservoir of millions of people some develop active TB disease. But there is hope because isoniazid preventive therapy (IPT) can cure latent TB infection. Despite promise since years, to provide IPT to those with latent TB infection, a lot more action needs to happen to effectively target this dormant TB pool.

Partnerships vital to combat TB, diabetes

Dr Pablo Antonio Kuri Morales, Under-Secretary for Prevention and Health Promotion, Mexico, said to CNS (Citizen News Service) that diabetes is associated with unhealthy lifestyles too, whereas TB is mostly affecting under-privileged people in our population. It is important for both TB and diabetes experts and programme people to understand how can the two interventions work together effectively so as to help increase public health outcomes of both programmes. We need to share information and data, and also seek collaboration with other ministries and partners who can help mitigate social determinants of TB and diabetes.

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