Diabetes and tuberculosis: <scp>A</scp>n important relationship

Bloomgarden, Zachary T.; Misra, Anoop

doi:10.1111/1753-0407.12547

Cited by 7 publications

(6 citation statements)

References 40 publications

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“…The concept of a syndemic refers to synergistic (often not directly associated with the index disease) health problems that affect the health of a population in the context of persistent social and economic inequalities . Both HIV and tuberculosis are common in some African, South Asian, and South American countries, and can contribute to insulin resistance and diabetes . Conversely, the presence of diabetes increases the risk of tuberculosis .…”

Section: Syndemics Of Diabetes With Other Diseasesmentioning

confidence: 99%

Diabetes in developing countries

Misra

Gopalan

Jayawardena

et al. 2019

Journal of Diabetes

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196

129

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Highlights• Diabetes in developing countries is increasing and often undiagnosed. In South Asians, diabetes and related metabolic abnormalities develop at a younger age and at a lower body mass index and waist circumference than in Whites. • Overall glycemic control and management of diabetes is suboptimal, driven by multiple factors (eg, unawareness, cost of drugs and insulin etc.), and the load of complications is high. • To stem this epidemic, strong actions for prevention and management are required using innovative and low-cost approaches. AbstractThere has been a rapid escalation of type 2 diabetes (T2D) in developing countries, with varied prevalence according to rural vs urban habitat and degree of urbanization. Some ethnic groups (eg, South Asians, other Asians, and Africans), develop diabetes a decade earlier and at a lower body mass index than Whites, have prominent abdominal obesity, and accelerated the conversion from prediabetes to diabetes. The burden of complications, both macro-and microvascular, is substantial, but also varies according to populations. The syndemics of diabetes with HIV or tuberculosis are prevalent in many developing countries and predispose to each other. Screening for diabetes in large populations living in diverse habitats may not be cost-effective, but targeted high-risk screening may have a place. The cost of diagnostic tests and scarcity of health manpower pose substantial hurdles in the diagnosis and monitoring of patients. Efforts for prevention remain rudimentary in most developing countries. The quality of care is largely poor; hence, a substantial number of patients do not achieve treatment goals. This is further amplified by a delay in seeking treatment, "fatalistic attitudes", high cost and non-availability of drugs and insulins. To counter these numerous challenges, a renewed political commitment and mandate for health promotion and disease prevention are urgently needed. Several low-cost innovative approaches have been trialed with encouraging outcomes, including training and deployment of non-medical allied health professionals and the use of mobile phones and telemedicine to deliver simple health messages for the prevention and management of T2D.

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Section: Syndemics Of Diabetes With Other Diseasesmentioning

confidence: 99%

Diabetes in developing countries

Misra

Gopalan

Jayawardena

et al. 2019

Journal of Diabetes

Self Cite

196

129

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“…Therefore, we speculate the lymph nodes of patients with TB concurrent diabetes mellitus are more likely to be damaged by Mtb than patients with only TB because of hyperglycemia compromising on some relevant innate and adaptive immunity mechanisms that are necessary for Mtb clearance in patients with T2DM. 32,33 A similar study has reported that lymphadenopathy was identified significantly more commonly in TB patients with DM than patients with only TB group (51.6% vs 35.0%). 34 The underlying mechanisms is still need to be determined.…”

Section: Discussionmentioning

confidence: 79%

Association of TyG Index with CT Features in Patients with Tuberculosis and Diabetes Mellitus

Yong¹,

Peng²,

Chen³

et al. 2022

IDR

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Background:The purpose of this study was to investigate the association of the triglyceride glucose (TyG) index, a surrogate marker of insulin resistance (IR) with a high sensitivity of 96.5% and a specificity of 85.0% for the diagnosis of IR, with computed tomography (CT) features in patients with tuberculosis and diabetes mellitus. Methods: A total of 247 subjects were enrolled from July, 2020 to May, 2021. The basic clinical features and CT features were analyzed. In addition, multivariate logistic regression analysis models were employed to evaluate the association of the TyG indicator with CT features in participants. Results: In the quartile groups of TyG index, air bronchial sign detection rate was 11.7%, 14.5%, 23.2%, and 44.1%; large segmented leafy shadow detection rate was 27.9%, 40.6%, 46.4%, and 66.2%; thick-walled cavity was found in 38.2%, 43.4%, 57.9%, and 69.1%; the rate of multiple cavities was 17.6%, 27.5%, 36.2%, 52.9%; the rate of lymph node enlargement was 22.1%, 17.4%, 28.9%, and 38.2%, respectively. In addition, the positive relation with the TyG index and the prevalence of abnormal CT signs was observed in the fully adjusted model: TyG, per one-unit increase: air bronchial sign: adjusted odds ratio (AOR) 3.92, 95% CI 1-15.35, P = 0.049; multiple cavities: AOR 4.1, 95% CI 1.26-13.31, P = 0.019; thick-walled cavity: AOR 2.89, 95% CI 1.05-8.03, P = 0.041. In quartile of TyG index, compared with patients in quartile 1, the AOR (95% CI) values for air bronchial sign in quartile 4 was 8.1 (1.7-44), p = 0.011; multiple cavities was 7.1 (1.7-32), p = 0.008; thickwalled cavity was 7.8 (1.9-34.7), p = 0.005. Conclusion:The present study showed that an increased TyG index was positively related to the severity of patients with T2DM-PTB.

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“…The data here showed that individuals with diabetes mellitus were twice as likely to have PTB compared with those without diabetes mellitus (aOR 2.07, 95% CI 1.76–2.44). The morbidity and mortality of PTB and diabetes mellitus remain high, especially when these two diseases occur together [ 18 ]. Our findings strongly suggest that TB control measures should be integrated with diabetes mellitus control programs.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity increases the risk of pulmonary tuberculosis: a nested case-control study using multi-source big data

Wang,

Song,

Wang

et al. 2024

BMC Pulm Med

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Background Some medical conditions may increase the risk of developing pulmonary tuberculosis (PTB); however, no systematic study on PTB-associated comorbidities and comorbidity clusters has been undertaken. Methods A nested case-control study was conducted from 2013 to 2017 using multi-source big data. We defined cases as patients with incident PTB, and we matched each case with four event-free controls using propensity score matching (PSM). Comorbidities diagnosed prior to PTB were defined with the International Classification of Diseases-10 (ICD-10). The longitudinal relationships between multimorbidity burden and PTB were analyzed using a generalized estimating equation. The associations between PTB and 30 comorbidities were examined using conditional logistic regression, and the comorbidity clusters were identified using network analysis. Results A total of 4265 cases and 17,060 controls were enrolled during the study period. A total of 849 (19.91%) cases and 1141 (6.69%) controls were multimorbid before the index date. Having 1, 2, and ≥ 3 comorbidities was associated with an increased risk of PTB (aOR 2.85–5.16). Fourteen out of thirty comorbidities were significantly associated with PTB (aOR 1.28–7.27), and the associations differed by sex and age. Network analysis identified three major clusters, mainly in the respiratory, circulatory, and endocrine/metabolic systems, in PTB cases. Conclusions Certain comorbidities involving multiple systems may significantly increase the risk of PTB. Enhanced awareness and surveillance of comorbidity are warranted to ensure early prevention and timely control of PTB.

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Diabetes and tuberculosis: An important relationship

Cited by 7 publications

References 40 publications

Diabetes in developing countries

Diabetes in developing countries

Association of TyG Index with CT Features in Patients with Tuberculosis and Diabetes Mellitus

Comorbidity increases the risk of pulmonary tuberculosis: a nested case-control study using multi-source big data

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