Abstract
Diabetes mellitus (DM) increases the risk of tuberculosis (TB) by 2-3 times and the risk of adverse TB treatment outcomes. Diabetes causes immunosuppression, is increasingly being recognized as an independent risk factor for tuberculosis, and the two often coexist and impact each other. There are two stages of tuberculosis (TB): latent TB infection and active TB disease. So that DM patients especially patients newly diagnosed with DM, systematic TB screening should be performed. TB causes “stress-induced hyperglycaemia” and this can make the management of DM more difficult. Treatment for drug-susceptible and drug-resistant TB is similar in patients without DM. Diabetes may also lead to severe disease, reactivation of dormant tuberculosis foci, and poor treatment outcomes. Tuberculosis as a disease entity on the other hand and some commonly used antituberculous medications separately may cause impaired glucose tolerance. Metformin is the first-line drug of choice for treating persons with DM if medication is needed to control elevated glucose levels. Insulin may have to be considered if blood glucose levels are very high or in those whose blood glucose levels are not controlled with oral hypoglycaemic drugs. Diabetic patients withs cardiovascular disease should be offeredlow dose aspirin and a statin, and need to be counselled about appropriate lifestyle management (smoking cessation, good diet and physical activity). The awareness of clinicians and managers of TB and diabetes programs on the effect of the interaction between these two disease entities very important not only for screening and but also managing diabetic patients with TB.
