Is there a connection between gestational diabetes mellitus, human immunodeficiency virus infection, and tuberculosis?

Abstract

SUMMARY Pregnancy is associated with insulin resistance similar to that found in type 2 diabetes mellitus (DM). The prevalence of gestational diabetes mellitus (GDM) in key tuberculosis (TB) endemic countries, such as India and China, has been increasing rapidly in the last decade and may be higher in human immunodeficiency virus (HIV) infected women. Pregnancy is also an independent risk factor for developing active TB; however, little is known about the interaction of GDM, HIV and TB. We review the epidemiology, immunology, and significant research gaps in understanding the interactions between GDM, pregnancy, and TB in women living with and those without HIV.

Pulmonary tuberculosis cases in pregnancy: perinatal outcomes and health promotion challenges in Indonesia

“…Our finding is consistent with a previous study, which stated that neonates born to mothers with TB have a higher risk of poor perinatal outcomes, including SGA and perinatal mortality [1,2]. Additionally, poor perinatal outcomes of gestational DM are LGA, intrauterine fetal death, and neonatal hypoglycemia [6,7].…”

“…One study in India showed that the integration of family planning programs and TB control programs had a mutual impact [10]. Additionally, early detection and intervention should be implemented for women at high risk of developing TB, such as those with DM to avoid poor glycemic control [6].…”

“…The World Health Organization defines gestational DM as the onset of carbohydrate intolerance during pregnancy [5]. The true prevalence and distribution of gestational DM are unknown, presumably due to lack of international consensus on screening or diagnosis [6]. The maternal complications of gestational DM include preeclampsia (26-40%) and cesarean delivery (52-60%).…”

“…At the same time, there is an increased risk of macrosomia (giant baby), intrauterine fetal death, prematurity, and neonatal hypoglycemia. [6,7].…”

Integrated Management of Type 2 Diabetes and Gestational Diabetes in the Context of Multi-Morbidity in Africa: A Systematic Review

“…Chronic comorbid conditions could include cardio-vascular diseases (e.g., hypertension) and/or infectious diseases (e.g., tuberculosis, Hepatitis B, HIV/AIDS) and/or vector borne diseases (e.g., malaria) [16]. Treatment of some of these diseases -such as antiretroviral therapy (ART) for HIVmay increase the likelihood of concomitant metabolic complications, with possible pre-existing opportunistic infections among others [10,13,[17][18][19][20][21][22][23][24][25][26][27][28], necessitating more complex and costly clinical management [16]. The multimorbidity caused by comorbid non-communicable and infectious chronic diseases [29], which include GDM and T2DM, has not been well studied, especially their integrated management into primary health care (PHC) in LMICs including all countries in Africa.…”