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Current Diabetes Reviews

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ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

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Research Article

Diabetes and TB: Confluence of Two Epidemic and Its Effect on Clinical Presentation

Author(s): Kumudha Dhamotharaswamy, Hemalatha Selvaraj*, Padmashree Lakshmanaperumal, Harsha R., Anuja S. Sasankan, Prabha Thangavelu, Menaka K. and Sivakumar Thangavel

Volume 20, Issue 1, 2024

Published on: 11 May, 2023

Article ID: e310323215348 Pages: 8

DOI: 10.2174/1573399819666230331113156

Price: $65

Abstract

Background: Tuberculosis (TB) has become a rising concern in low-income countries, particularly in those with Human Immuno Deficiency Virus (HIV) epidemics, and type 2 diabetes has emerged as a significant global chronic health problem, owing to increases in obesity, lifestyle changes, and ageing populations. Diabetes has been identified as a major risk factor for the development of TB. Despite the fact that diabetes imparts a substantially lower risk of TB (3-fold) as compared to HIV (>20-fold), in communities where the number of DM patients is high, the contribution of diabetes to TB might be bigger than HIV.

Methods: This review will focus on the link between TB and diabetes, which is now one of the most important topics for physicians since diabetes impacts the clinical presentation and outcome of TB and vice versa.

Results: Though TB is more common in type 1 diabetes, the extent of the problem in type 2 diabetes should be taken into account with equal care, as type 2 diabetes affects a substantially higher number of individuals.

Conclusions: Diabetes patients are more vulnerable to infections because of their impaired immune systems. Increased glucose level leads to a rise in the infection status among TB patients and also leads to a rise in various complications. Extensive and increased screening for both TB and DM over years can help diagnose disease priorly and help in better management. TB, when diagnosed in its early stages, can be easily eradicated.

[1]
Baker MA, Harries AD, Jeon CY, et al. The impact of diabetes on tuberculosis treatment outcomes: A systematic review. BMC Med 2011; 9(1): 81.
[http://dx.doi.org/10.1186/1741-7015-9-81] [PMID: 21722362]
[2]
TB. Available from: https://www.who.int/news-room/fact-sheets/detail/TB(accessed 2021-12-20).
[3]
Girardi E, Sañé Schepisi M, Goletti D, et al. The global dynamics of diabetes and tuberculosis: the impact of migration and policy implications. Int J Infect Dis 2017; 56: 45-53.
[http://dx.doi.org/10.1016/j.ijid.2017.01.018] [PMID: 28153793]
[4]
Diabetes.. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes(Accessed on: 2021-12-20)
[5]
Ruslami R, Aarnoutse RE, Alisjahbana B, Van Der Ven AJAM, Van Crevel R. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop Med Int Health 2010; 15(11): 1289-99.
[http://dx.doi.org/10.1111/j.1365-3156.2010.02625.x] [PMID: 20955495]
[6]
Dobler CC, Flack JR, Marks GB. Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study. BMJ Open 2012; 2(1): e000666.
[http://dx.doi.org/10.1136/bmjopen-2011-000666] [PMID: 22331390]
[7]
Rao PV. Persons with type 2 diabetes and co-morbid active tuberculosis should be treated with insulin. Int J Diab Dev Countries 1999; 19: 79-86.
[8]
Rajalakshmi S. Yugi’s pramegam and diebetes mellitus: An analogue. Bull Indian Inst Hist Med Hyderabad 1999; 29(1): 83-7.
[9]
Baghaei P, Marjani M, Javanmard P, Tabarsi P, Masjedi MR. Diabetes mellitus and tuberculosis facts and controversies. J Diabetes Metab Disord 2013; 12(1): 58.
[http://dx.doi.org/10.1186/2251-6581-12-58] [PMID: 24360398]
[10]
IDF. IDF Diabetes Atlas. sixth. Brussels Available from: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=IDF.+IDF+Diabetes+Atlas.+sixth.+Brussels%3A+International+Diabetes+Federation%3B+2013.&btnG=(accessed 2021-12-20).
[11]
Gassasse Z, Smith D, Finer S, Gallo V. Association between urbanisation and type 2 diabetes: An ecological study. BMJ Glob Health 2017; 2(4): e000473.
[http://dx.doi.org/10.1136/bmjgh-2017-000473] [PMID: 29104770]
[12]
Siddiqui AN, Khayyam KU, Sharma M. Effect of Diabetes Mellitus on tuberculosis treatment outcome and adverse reactions in patients receiving directly observed treatment strategy in India: A prospective study. BioMed Res Int 2016; 2016: 1-11.
[http://dx.doi.org/10.1155/2016/7273935] [PMID: 27642601]
[13]
Riza AL, Pearson F, Ugarte-Gil C, et al. Clinical management of concurrent diabetes and tuberculosis and the implications for patient services. Lancet Diabetes Endocrinol 2014; 2(9): 740-53.
[http://dx.doi.org/10.1016/S2213-8587(14)70110-X] [PMID: 25194887]
[14]
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27(5): 1047-53.
[http://dx.doi.org/10.2337/diacare.27.5.1047] [PMID: 15111519]
[15]
Internal medicine. Major Complications of Diabetes Mellitus in Africa. 2000. Available from: pascal-francis.inist.fr
[16]
Restrepo BI. Diabetes and tuberculosis Microbiol Spectr 2016; 4(6): 4.6.48.
[http://dx.doi.org/10.1128/microbiolspec.TNMI7-0023-2016] [PMID: 28084206]
[17]
Chiang CY, Lee JJ, Chien ST, et al. Glycemic control and radiographic manifestations of tuberculosis in diabetic patients. PLoS One 2014; 9(4): e93397.
[http://dx.doi.org/10.1371/journal.pone.0093397] [PMID: 24699457]
[18]
Alisjahbana B, Sahiratmadja E, Nelwan EJ, et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis 2007; 45(4): 428-35.
[http://dx.doi.org/10.1086/519841] [PMID: 17638189]
[19]
Solá E, Rivera C, Mangual M, Martinez J, Rivera K, Fernandez R. Diabetes mellitus: an important risk factor for reactivation of tuberculosis. Endocrinol Diabetes Metab Case Rep 2016; 2016: 16-0035.
[http://dx.doi.org/10.1530/EDM-16-0035] [PMID: 27482384]
[20]
Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of TB-National Prevention Information Network-Connecting public health professionals with trusted information and each other. Available from: https://npin.cdc.gov/publication/updated-guidelines-use-nucleic-acid-amplification-tests-diagnosis-TB(Accessed on: 2021-12-20)
[21]
Christopher DJ, Cherian Kuruvilla L, Sarangi PK, Thangakunam B, Irodi A, Shankar D. chest radiologic pattern in diabetic patients without pulmonary TB (PTB).TB. European Respiratory Society 2019; p. p. PA2973.
[http://dx.doi.org/10.1183/13993003.congress-2019.PA2973]
[22]
Mahishale V, Avuthu S, Patil B, et al. Effect of poor glycemic control in newly diagnosed patients with smear-positive pulmonary tuberculosis and Type-2 Diabetes Mellitus. Iran J Med Sci 2017; 42(2): 144-51.
[23]
Dooley K, Tang T, Golub J, et al. Impact of diabetes mellitus on treatment outcomes of patients with active TB. Am J Trop Med Hyg 2009; 80(4): 634-9.
[24]
Pimazoni A. The Impact of TB treatment on glycaemic control and the significant response to rosiglitazone. Case Reports 2009; 16: bcr0920080994.
[http://dx.doi.org/10.1136/bcr.09.2008.0994]
[25]
Amrit G. Tuberculosis and diabetes: An appraisal. Indian J Tuberculosis 2000; 47(1): 3-8.
[26]
Panic N, Maetzel H, Bulajic M, Radovanovic M, Löhr JM, Pancreatic TB. Pancreatic tuberculosis: A systematic review of symptoms, diagnosis and treatment. United European Gastroenterol J 2020; 8(4): 396-402.
[http://dx.doi.org/10.1177/2050640620902353] [PMID: 32213022]
[27]
Yamashiro S, Kawakami K, Uezu K, et al. Lower expression of Th1-related cytokines and inducible nitric oxide synthase in mice with streptozotocin-induced diabetes mellitus infected with Mycobacterium tuberculosis. Clin Exp Immunol 2004; 139(1): 57-64.
[http://dx.doi.org/10.1111/j.1365-2249.2005.02677.x] [PMID: 15606614]
[28]
Geerlings S. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999; 26(3-4): 259-65.
[http://dx.doi.org/10.1111/j.1574-695X.1999.tb01397.x]
[29]
Martinez N, Kornfeld H. Diabetes and immunity to Tuberculosis. Eur J Immunol 2014; 44(3): 617-26.
[http://dx.doi.org/10.1002/eji.201344301 ]
[30]
Restrepo B. Host-pathogen interactions in TB patients with Type 2 Diabetes Mellitus. Tuberculosis 2013; 93: S10-4.
[31]
Ayelign B, Negash M, Genetu M, Wondmagegn T, Shibabaw T. Immunological impacts of diabetes on the susceptibility of mycobacterium tuberculosis. J Immunol Res 2019; 2019: 1-8.
[http://dx.doi.org/10.1155/2019/6196532] [PMID: 31583258]
[32]
Martinez N, Ketheesan N, et al. Impaired recognition of mycobacterium tuberculosis by alveolar macrophages from diabetic mice. J Infect Dis 2016; 214(11): 1629-37.
[33]
Immunological Response to Mycobacterium TB Infection in Blood from Type 2 Diabetes Patients. Elsevier 2016.
[34]
Kroon EE, Coussens AK, Kinnear C, et al. Neutrophils: Innate effectors of TB resistance? Front Immunol 2018; 9(11): 2637.
[http://dx.doi.org/10.3389/fimmu.2018.02637] [PMID: 30487797]
[35]
Nathella PK, Immunology SB. Influence of Diabetes Mellitus on Immunity to Human TB. Wiley Online Library 2017; 152(1): 13-24.
[http://dx.doi.org/10.1111/imm.12762]
[36]
Kumar NP, Moideen K, George PJ, Dolla C, Kumaran P, Babu S. Coincident diabetes mellitus modulates Th1-, Th2-, and Th17-cell responses in latent tuberculosis in an IL-10- and TGF-β-dependent manner. Eur J Immunol 2016; 46(2): 390-9.
[http://dx.doi.org/10.1002/eji.201545973]
[37]
Al-Attiyah R. Mycobacterial Antigen-induced T Helper Type 1 (Th1) and Th2 Reactivity of Peripheral Blood Mononuclear Cells from Diabetic and Non-diabetic TB Patients. Wiley Online Library 2009; 158: 64-73.
[http://dx.doi.org/10.1111/j.1365-2249.2009.04000.x] [PMID: 19737232]
[38]
Lönnroth K, Corbett E, Golub J, et al. Systematic screening for active tuberculosis: rationale, definitions and key considerations. State of the art series Active case finding/screening Number 1 in the series Int J Tuberc Lung Dis 2013; 17(3): 289-98.
[http://dx.doi.org/10.5588/ijtld.12.0797] [PMID: 23407219]
[39]
Jali M, Mahishale VK, Hiremath MB. Bidirectional Screening of TB Patients for Diabetes Mellitus and Diabetes Patients for TB. Diabetes Metab J 2013; 37(4): 291.
[http://dx.doi.org/10.4093/dmj.2013.37.4.291] [PMID: 23991408]
[40]
Harries AD, Lin Y, Satyanarayana S, et al. The looming epidemic of diabetes-associated TB: Learning lessons from HIV-Associated TB. Int J TB Lung Dis 2011; 15(11): 1436-45.
[http://dx.doi.org/10.5588/ijtld.11.0503] [PMID: 21902876]
[41]
Sen T, Joshi SR, Udwadia ZF. Tuberculosis and diabetes mellitus: Merging epidemics. J Assoc Physicians India 2009; 57: 399-404.
[42]
Lin Y, Li L, Mi F, et al. Screening patients with diabetes mellitus for tuberculosis in China. Trop Med Int Health 2012; 17(10): 1302-8.
[http://dx.doi.org/10.1111/j.1365-3156.2012.03069.x] [PMID: 22830951]
[43]
Screening of patients with diabetes mellitus for tuberculosis in India. Trop Med Int Health 2013; 18(5): 646-54.
[http://dx.doi.org/10.1111/tmi.12083] [PMID: 23448175]
[44]
Kumar NP, George PJ, Kumaran P, Dolla CK, Nutman TB, Babu S. Diminished systemic and antigen-specific type 1, type 17, and other proinflammatory cytokines in diabetic and prediabetic individuals with latent Mycobacterium tuberculosis infection. J Infect Dis 2014; 210(10): 1670-8.
[http://dx.doi.org/10.1093/infdis/jiu329] [PMID: 24907382]
[45]
Lu LL, Chung AW, Rosebrock TR, et al. A functional role for antibodies in tuberculosis. Cell 2016; 167(2): 433-43.
[http://dx.doi.org/10.1016/j.cell.2016.08.072] [PMID: 27667685]
[46]
Berry MPR, Graham CM, McNab FW, et al. An interferon-inducible neutrophil-driven blood transcriptional signature in human tuberculosis. Nature 2010; 466(7309): 973-7.
[http://dx.doi.org/10.1038/nature09247] [PMID: 20725040]
[47]
Nwabudike L. Intradermal reactions to purified protein derivative in patients with diabetes mellitus. Rom J Intern Med 2005; 43(1-2): 127-32.
[48]
Lönnroth K, Roglic G, Harries AD, Improving TB. Improving tuberculosis prevention and care through addressing the global diabetes epidemic: from evidence to policy and practice. Lancet Diabetes Endocrinol 2014; 2(9): 730-9.
[http://dx.doi.org/10.1016/S2213-8587(14)70109-3] [PMID: 25194886]
[49]
Latent tuberculosis infection updated and consolidated guidelines for programmatic management. WHO Guidelines approved by the Guidelines Review Committee. Geneva: World Helath Organization 2018; 9-29.
[50]
Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M. Diagnosis for latent tuberculosis infection: new alternatives. Front Immunol 2020; 11: 2006.
[http://dx.doi.org/10.3389/fimmu.2020.02006] [PMID: 33013856]
[51]
van Crevel R, Critchley JA. The interaction of diabetes and tuberculosis: translating research to policy and practice. Trop Med Infecti Dis 2021; 86(1): 8.
[http://dx.doi.org/10.3390/tropicalmed6010008]
[52]
Niazi AK, Kalra S. Diabetes and tuberculosis: a review of the role of optimal glycemic control. J Diabetes Metab Disord 2012; 11(1): 28.
[http://dx.doi.org/10.1186/2251-6581-11-28] [PMID: 23497638]
[53]
Leung CC, Yew WW, Mok TYW, et al. Effects of diabetes mellitus on the clinical presentation and treatment response in tuberculosis. Respirology 2017; 22(6): 1225-32.
[http://dx.doi.org/10.1111/resp.13017] [PMID: 28244689]
[54]
Mtabho CM, Semvua HH, van den Boogaard J, et al. Effect of diabetes mellitus on TB drug concentrations in Tanzanian patients. J Antimicrob Chemother 2019; 74(12): 3537-45.
[http://dx.doi.org/10.1093/jac/dkz368] [PMID: 31651031]
[55]
Nijland HMJ, Ruslami R, Stalenhoef JE, et al. Exposure to rifampicin is strongly reduced in patients with tuberculosis and type 2 diabetes. Clin Infect Dis 2006; 43(7): 848-54.
[http://dx.doi.org/10.1086/507543] [PMID: 16941365]
[56]
Ruslami R, Nijland HMJ, Adhiarta IGN, et al. Pharmacokinetics of AntiTB drugs in pulmonary TB patients with Type 2 Diabetes. Antimicrob Agents Chemother 2010; 54(3): 1068-74.
[http://dx.doi.org/10.1128/AAC.00447-09] [PMID: 20038625]
[57]
Lee PH, Lin HC, Huang ASE, Wei SH, Lai MS, Lin HH. Diabetes and risk of tuberculosis relapse: Nationwide nested case-control study. PLoS One 2014; 9(3): e92623.
[http://dx.doi.org/10.1371/journal.pone.0092623] [PMID: 24663327]
[58]
Pablos-Méndez A, Blustein J, Knirsch CA. The role of diabetes mellitus in the higher prevalence of tuberculosis among Hispanics. Am J Public Health 1997; 87(4): 574-9.
[http://dx.doi.org/10.2105/AJPH.87.4.574] [PMID: 9146434]
[59]
Jeon CY, Murray MB. Correction: Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med 2008; 5(8): e181.
[http://dx.doi.org/10.1371/journal.pmed.0050181]
[60]
Naidoo K, Dookie N. Insights into Recurrent TB: Relapse Versus Reinfection and Related Risk Factors. In: TB InTech. 2018.
[http://dx.doi.org/10.5772/intechopen.73601]
[61]
Tegegne BS, Mengesha MM, Teferra AA, Awoke MA, Habtewold TD. Association between diabetes mellitus and multi-drug-resistant tuberculosis: evidence from a systematic review and meta-analysis. Syst Rev 2018; 7(1): 161.
[http://dx.doi.org/10.1186/s13643-018-0828-0] [PMID: 30322409]
[62]
Vilchèze C, Jacobs WR Jr. Resistance to isoniazid and ethionamide in Mycobacterium tuberculosis : Genes, mutations, and causalities. Microbiol Spectr 2014; 2(4): 2.4.01.
[http://dx.doi.org/10.1128/microbiolspec.MGM2-0014-2013] [PMID: 26104204]
[63]
Targeted tuberculin testing and treatment of latent TB infection. Am J Respir Crit Care Med 2000; 161 (suppl. 3): S221-47.
[http://dx.doi.org/10.1164/ajrccm.161.supplement_3.ats600] [PMID: 10764341]
[64]
Smieja Mj, Marchetti CA, Cook DJ, Smaill F M. Isoniazid for Preventing TB in Non-HIV Infected Persons. Cochrane Database of Sys Rev 2000; 1999(2): CD001363.
[http://dx.doi.org/10.1002/14651858]
[65]
Lin SY, Chiu YW, Lu PL, et al. Three months of rifapentine and isoniazid for latent tuberculosis infection in hemodialysis patients: High rates of adverse events. J Microbiol Immunol Infect 2019; 52(1): 158-62.
[http://dx.doi.org/10.1016/j.jmii.2018.05.003] [PMID: 29907535]
[66]
Sterling TR, Villarino ME, Borisov AS, et al. Three months of rifapentine and isoniazid for latent tuberculosis infection. N Engl J Med 2011; 365(23): 2155-66.
[http://dx.doi.org/10.1056/NEJMoa1104875] [PMID: 22150035]

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