Diabetes and Tuberculosis

Summaryobjectives To review the current knowledge about tuberculosis (TB) and diabetes, assessing the implication of the global increase of diabetes for TB control and patient care.methods Systematic literature review. results Using public databases, it can be estimated that 12.6% (95% CI 9.2-17.3%) of new TB cases in the 10 countries with the highest TB burden will be attributable to TB in 2030, a relative increase of 25.5% compared to 2010. Diabetes is associated with a higher age and body weight among patients with TB, but probably not with a specific clinical presentation of TB. Rifampicin hampers glycemic control by increasing the metabolism of most oral antidiabetic drugs, while diabetes patients may have lower concentrations of anti-TB drugs. This might be one factor contributing to higher TB treatment failure rates.conclusions The global epidemic of diabetes has implications for control and treatment of TB. Prospective studies are needed to improve prevention, early detection and treatment of concomitant diabetes and TB, especially in developing countries.

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“…1999). Long duration of illness and poor glucose control may increase the risk of TB (Banyai 1959; Swai et al. 1990).…”

Section: Effect Of Dm On the Tb Epidemicmentioning

confidence: 99%

Implications of the global increase of diabetes for tuberculosis control and patient care

Ruslami

Aarnoutse

Alisjahbana

et al. 2010

Tropical Medicine &Amp; International Health

206

181

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“…In developed countries, studies dating to the first half of the past century demonstrated considerable increase in the frequency of tuberculosis among patients with diabetes (4,5,18), although the proportion with comorbidity has ranged widely from 1.0 (19) to 9.3% (20). Other studies have shown a higher frequency of diabetes among individuals with tuberculosis (21,22).…”

Section: Figure 1-impact Of Undersampling and Increase In Interval Bementioning

confidence: 99%

Tuberculosis and Diabetes in Southern Mexico

et al. 2004

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OBJECTIVE—To determine the impact of diabetes on the rates of tuberculosis in a region where both diseases are prevalent. RESEARCH DESIGN AND METHODS—Data from a population-based cohort of patients with pulmonary tuberculosis undergoing clinical and mycobacteriologic evaluation (isolation, identification, drug-susceptibility testing, and IS6110-based genotyping and spoligotyping) were linked to the 2000 National Health Survey (ENSA2000), a national probabilistic, polystage, stratified, cluster household survey of the civilian, noninstitutionalized population of Mexico. RESULTS—From March 1995 to March 2003, 581 patients with Mycobacterium tuberculosis culture and fingerprint were diagnosed, 29.6% of whom had been diagnosed previously with diabetes by a physician. According to the ENSA2000, the estimated prevalence of diabetes in the study area was 5.3% (95% CI 4.1–6.5). The estimated rates of tuberculosis for the study area were greater for patients with diabetes than for nondiabetic individuals (209.5 vs. 30.7 per 100,000 person-years, P < 0.0001). CONCLUSIONS—In this setting, the rate of tuberculosis was increased 6.8-fold (95% CI 5.7–8.2, P < 0.0001) in patients with diabetes due to increases in both reactivated and recently transmitted infection. Comorbidity with diabetes may increase tuberculosis rates as much as coinfection with human immunodeficiency virus (HIV), with important implications for the allocation of health care resources.

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“…O que se evidencia é uma maior incidên-cia de certos microorganismos em DM, como Staphylococcus aureus, bacilos Gram-negativos (BGN) e Mycobacterium tuberculosis. Em estudos da primeira metade do século XX, a tuberculose se apresentava 3-4 vezes mais incidente em diabéticos (9). Apesar da falta de evidências semelhantes na literatura, a experiência ainda não publicada do nosso serviço tem mostrado que, no caso das pneumonias por BGN, muitas vezes ocorre uma rápida e progressiva lesão pulmonar, levando muitos doentes ao óbito em curto espaço de tempo.…”

Section: Infecções Comunsunclassified

Aspectos relevantes da interface entre diabetes mellitus e infecção

Rocha

Baggio

Cunha

et al. 2002

Arq Bras Endocrinol Metab

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RESUMOO diabetes mellitus (DM) é uma doença de alta prevalência nas sociedades modernas, na maioria das vezes com tratamento inadequado ou ausente. Apesar de geralmente considerado como fator de risco independente para ocorrência e gravidade de infecções em geral, o DM não apresenta evidência clínica forte de sua relação com infecção. Observase, porém, uma maior ocorrência de certas infecções em pacientes com DM, com curso menos favorável para algumas delas. Há também tipos de infecção quase exclusivos de pacientes com DM. Experimentalmente, observa-se depressão da atividade dos neutrófilos, menor eficiência da imunidade celular, alteração dos sistemas antioxidantes e menor produção de interleucinas. Com relação às infecções comuns, as que envolvem o trato respiratório não têm comprovadamente maior gravidade em pacientes com DM, exceção feita ao pneumococo -por isso a recomendação para sua vacinação contra S. pneumoniae e influenza. Quanto ao trato urinário, há maior ocorrência de bacteriúria assintomáti-ca em mulheres com DM, com maiores índices de pielonefrite, necrose papilar, abscesso perinéfrico, pielonefrite xantogranulomatosa, e cistite e pielonefrite gangrenosas. Periodontite e infecções de partes moles são também mais comuns no DM. Cada tipo de infecção é associado a germes típicos, e seu conhecimento é fundamental para um tratamento inicial adequado. As infecções quase exclusivas de pacientes com DM incluem otite externa maligna, mucormicose rinocerebral, colecistite gangrenosa e o somatório de alterações que caracterizam o pé diabético. O conhecimento destas infecções assume maior importância por requererem freqüentemente uma abordagem multidisciplinar, envolvendo endocrinologistas, infectologistas, cirurgiões vasculares e nefrologistas, dentre outros. Diabetes mellitus (DM) is a highly prevalent disease in modern societies, most of the times being either inappropriately treated or not treated at all. Though generally considered to be an independent risk factor for the occurrence and severity of infections in general, DM has not been clinically proven to have any strong association with infection. There are, however, certain infections that are more common in DM, sometimes with a less favorable course than in non-diabetics. Other types of infection affect almost exclusively patients with DM. Experimentally, DM patients have a depressed neutrophil activity, a less effective cell mediated immunity, altered antioxidant systems and diminished interleukin synthesis. Regarding common infections, those affecting the respiratory tract have not been proven to be more serious in DM patients, with the exception of S. pneumoniae infections -thus the recommendation to vaccinate them against pneumococcus and influenza. As for urinary tract infections, bacteriuria takes place more commonly in women with DM, more frequently complicated by pyelonephritis, papillary necrosis, xanthogranulomatous pyelonephritis and gangrenous cystitis/ pyelonephritis. Periodontitis and soft-tissue infections are also more common

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Diabetes and Tuberculosis

Cited by 14 publications

References 5 publications

Implications of the global increase of diabetes for tuberculosis control and patient care

Implications of the global increase of diabetes for tuberculosis control and patient care

Tuberculosis and Diabetes in Southern Mexico

Aspectos relevantes da interface entre diabetes mellitus e infecção

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