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Active Pulmonary Tuberculosis - Its Impact On Patients With Diabetes

The most frequent cause of death from microbial illnesses worldwide is active pulmonary tuberculosis.

The immune system is weakened by uncontrolled diabetes, which promotes the growth of tuberculosis bacilli and disease.

High blood sugar levels are a defining feature of diabetes mellitus (DM), a complex metabolic disorder caused by insufficient insulin production or insulin-resistant cells.

The typical signs of high blood sugar include increased thirst and hunger as well as frequent urination.

Numerous experts have expressed concern about the connection between the emerging epidemics of diabetes mellitus (DM) and tuberculosis (TB) in populations with low socioeconomic status.

The alarming increase in DM prevalence and the highest TB burden in the world place a double burden on low-income countries.

The possibility of a connection between the two diseases will further complicate an already difficult situation and raise additional concerns.

What Is Tuberculosis?

The infectious disease known as tuberculosis can lead to an infection in the lungs as well as other tissues in the body. It most frequently affects your lungs, but it also has the potential to affect other organs in your body, such as your spine, brain, or kidneys. The word "tuberculosis" originates from a Latin word that means "nodule," which is another way of saying "something that sticks out."

People who become infected with tuberculosis do not necessarily develop symptoms of the disease; however, if symptoms do develop, treatment is required.

If you are infected with the bacterium that causes tuberculosis, but you do not have any symptoms of the disease, you are said to have inactive tuberculosis or latent tuberculosis infection (also known as latent TB). The symptoms of tuberculosis (TB) may have subsided, but the infection is actually dormant (sleeping) within your body.

If you’re infected, develop symptoms and are contagious, you have active tuberculosis or tuberculosis disease (TB disease).

The three stages of tuberculosis are as follows:

  • Primary infection.
  • Latent tuberculosis infection.
  • Active tuberculosis disease.

What Are The Different Kinds Of Tuberculosis?

You might also hear about other forms of tuberculosis (TB), in addition to active or latent, including the most common form, which affects the lungs and is called pulmonary tuberculosis. However, the bacterium can also cause tuberculosis in areas of the body other than the lungs. This condition is known as extrapulmonary tuberculosis or TB that occurs outside of the lungs. It's also possible that you've heard of systemic miliary tuberculosis, which can spread throughout your body and lead to the following symptoms and conditions:

  • Lymphadenitis of the neck, also known as scrofula lymphadenitis or tuberculous lymphadenitis.
  • Hepatitis, an infection of the liver.
  • Addison's disease, a condition that affects the adrenal glands.
  • A condition known as Pott's disease, which is also known as spinal tuberculosis or tuberculosis spondylitis.
  • A condition known as sterile pyuria, or an abnormally high number of white blood cells in the urine.
  • Meningitis, an inflammation that affects the membranes that surround your brain.

What Is Diabetes?

Diabetes is a condition in which the body is unable to process blood glucose, also known as blood sugar. This results in high blood sugar levels. Diabetes is a complex disease that can take many forms and responds differently to different treatments.

There are an estimated 34.2 million people in the United States who are living with diabetes, both diagnosed and undiagnosed. This number includes people of all ages.

Diabetes, if not properly managed on an ongoing and careful basis, can result in a buildup of sugars in the blood, which can increase the risk of dangerous complications such as stroke and heart disease.

There are many subtypes of diabetes, and the management of the condition varies greatly depending on which type a person has. There are many different kinds of diabetes, and not all of them are caused by being overweight or living a sedentary lifestyle. Some have been there since childhood.

Diabetes mellitus type 1, type 2, and gestational diabetes are the most common types of diabetes, and we will discuss each of these in greater detail below. Monogenic diabetes and diabetes related to cystic fibrosis are two forms of diabetes that are significantly less common.

How Tuberculosis Affects Patients With Diabetes

Diabetes mellitus (DM) has been linked in multiple studies to an increased risk of tuberculosis (TB), as well as an increased prevalence of DM among patients diagnosed with TB. Diabetes not only increases the likelihood of developing tuberculosis but is also a risk factor for the development of complications during treatment for tuberculosis, including death. It is common knowledge that the presence of diabetes makes these risks more severe, particularly if a person's blood glucose levels are elevated.

This is an analytical study of case-control correlations. The radiographs of patients with pulmonary tuberculosis whose diabetes was proven and the same number of radiographs of patients with tuberculosis without diabetics (as approved and recorded in the profile of the patients) were collected from the tuberculosis center of zabol city and will be delivered to the radiologists with no information about patients.

Using the Spss program, descriptive statistics are collected and displayed as (frequency, percent) graphs. The analysis and comparison of the outcomes in diabetic and non-diabetic individuals are conducted using a test with a 0/05 level of significance.

Studies on the prevalence of pulmonary tuberculosis in Iranian diabetic patients are scarce. In the province of Sistan and Baluchistan, the prevalence of TB is estimated to be 48.5 cases per 100,000 people. According to the study, the rate of tuberculosis in diabetic patients is higher than the general population of Iran and global statistics of 140 per 100,000 people. Another study in Iran found this rate to be 682 per 100,000 people, which is higher than the general population of Iran and the latest global PTB statistics.

A 2004 Hernandez study of 791 diabetic Canadians found more positive than negative smears. In some articles, diabetes only increases the prevalence of pulmonary tuberculosis and not extrapulmonary tuberculosis.

Other articles from other Third World nations have covered the connection between diabetes and tuberculosis.

Mugusi discovered that the prevalence of diabetes was four times higher in tuberculosis patients than in healthy controls in a study of 506 TB patients and 693 controls in Tanzania.

The findings of this study indicate that patients with underlying factors for tuberculosis are more likely to develop diabetes, especially in Iran.

It is simple to prevent and identify infections with tuberculosis. A tuberculin skin test (5 units) can be used to determine this. Reach the objective and, if necessary, recommend isoniazid (or other medications for prophylaxis).

A female Caucasian doctor checking the blood sugar level of an elderly woman wearing a grey t-shirt
A female Caucasian doctor checking the blood sugar level of an elderly woman wearing a grey t-shirt

People Also Ask

What Is The Relationship Between Diabetes And Tuberculosis?

People who are diabetic and who are also infected with tuberculosis have an increased risk of developing tuberculosis disease and becoming ill with TB. If a person has diabetes and an untreated latent case of tuberculosis infection, they have a greater risk of developing tuberculosis disease than someone who does not have diabetes.

Why Is Diabetes High Risk For TB?

Through a variety of mechanisms, diabetes mellitus may increase susceptibility to pulmonary tuberculosis. Hyperglycemia, cellular insulinopenia, and the indirect effect on macrophages and lymphocyte function reduce TB containment.

Can Diabetes Cause TB?

Both the incidence and mortality rates of tuberculosis are affected by the prevalence of diabetes. It increases the risk of TB disease, death during treatment, relapse after treatment, and multidrug-resistant TB.

How Is Diabetes Treated With TB?

Insulin should be used aggressively in the treatment of diabetes and tuberculosis. If an individual with active tuberculosis and diabetes cannot be adequately managed with oral hypoglycemic medications, insulin must be used instead. The effectiveness, safety, tolerability, and convenience of an insulin regimen should all be taken into consideration.


The treatment outcomes for TB patients who also have diabetes are significantly worse than those for patients who do not also have diabetes as a comorbid condition. This was especially true for outcomes such as mortality and treatment failure. In light of the growing prevalence of diabetes mellitus, in particular in nations where the incidence of active pulmonary tuberculosis is still relatively high, the provision of comprehensive screening programs may prove to be beneficial for the early diagnosis and treatment of diabetes among TB patients and vice versa. This is especially the case in countries where the burden of diabetes mellitus is particularly high.

About The Authors

Suleman Shah

Suleman Shah - Suleman Shah is a researcher and freelance writer. As a researcher, he has worked with MNS University of Agriculture, Multan (Pakistan) and Texas A & M University (USA). He regularly writes science articles and blogs for science news website immersse.com and open access publishers OA Publishing London and Scientific Times. He loves to keep himself updated on scientific developments and convert these developments into everyday language to update the readers about the developments in the scientific era. His primary research focus is Plant sciences, and he contributed to this field by publishing his research in scientific journals and presenting his work at many Conferences. Shah graduated from the University of Agriculture Faisalabad (Pakistan) and started his professional carrier with Jaffer Agro Services and later with the Agriculture Department of the Government of Pakistan. His research interest compelled and attracted him to proceed with his carrier in Plant sciences research. So, he started his Ph.D. in Soil Science at MNS University of Agriculture Multan (Pakistan). Later, he started working as a visiting scholar with Texas A&M University (USA). Shah’s experience with big Open Excess publishers like Springers, Frontiers, MDPI, etc., testified to his belief in Open Access as a barrier-removing mechanism between researchers and the readers of their research. Shah believes that Open Access is revolutionizing the publication process and benefitting research in all fields.

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