The Interaction Between Diabetes Mellitus and Tuberculosis: Epidemiology, Screening, and Clinical Management

Tuberculosis (TB) is usually a preventable and curable disease, yet it remains the leading cause of death due to an infectious agent. Diabetes mellitus (DM) is a chronic metabolic disorder with ∼589 million adults living with it worldwide. Although the two diseases differ in etiology, pathophysiology, and socioeconomic burden, there is a significant link between them. Individuals with diabetes have a 1.9 times higher risk of developing TB. The co-occurrence of DM with TB compromises adaptive and innate immune responses, thereby increasing susceptibility to infections. The clinical indicators of TB in patients with DM are severe and show atypical radiological findings. World Health Organization (WHO) recommends that TB screening for DM individuals be conducted in settings where the TB prevalence in the general population is 100/100,000 population. TB treatment regimen in people with DM is in accordance with WHO guidelines and includes an initial intensive phase followed by a continuation phase. TB-DM co-occurrence is a significant global health challenge.