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OpEdNews Op Eds    H3'ed 11/2/15

Avert the looming TB-diabetes co-epidemic before it gets too late

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Shobha Shukla, CNS (Citizen News Service)

TB-Diabetes epidemics have joined hands. Will our programmes join hands?
TB-Diabetes epidemics have joined hands. Will our programmes join hands?
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(CNS): The global picture presents a bleak scenario of the double burden of TB and diabetes, in so much as a communicable and a non-communicable disease seem to have joined hands to threaten public health. That's why the forthcoming first-ever Global TB Diabetes Summit in Indonesia becomes important for galvanizing effective and collaborative public health responses.

The global data

Diabetes: According to the latest figures of the Diabetes Atlas 2014, 387 million people were living with diabetes mellitus (DM) in 2014 and 4.9 million died of diabetes related illness. Globally 1 out of 12 person has DM (prevalence of 8.3%), and 50% of them do not know about their condition.

77% of those with DM live in low and middle income countries.

TB: As per WHO's Global TB Report 2015, 9.6 million people fell ill with TB in 2014, and 1.5 million people died from it. Only 63% of those estimated to be having TB were notified to national TB programmes. This means that worldwide, 37% of new cases went undiagnosed or were not reported, reflecting a gap in both reporting of detected cases and access to care. Of the 9.6 million new TB cases in 2014, 58% were in the South-East Asia and Western Pacific regions.

TB and diabetes exacerbate each other

TB and diabetes interact with each other on a number of levels. Diabetes triples a person's risk of developing TB. Studies have found that DM in TB patients is associated with poor TB treatment outcomes--possible delay in sputum culture conversion-- increased risk of TB treatment failure/TB related deaths and also increased risk of recurrence of TB after successful treatment.

TB, on the other hand, can temporarily increase the level of blood sugar, which is a risk factor for developing DM. Moreover, some drugs used to treat TB (especially rifampicin) can make it more difficult to control diabetes due to the way that they interact with oral diabetes medications. There are growing concerns that oral diabetes medicines can decrease the effectiveness of TB medicines.

Recent studies have shown that 16%--46% of people living with TB also have diabetes, and many are unaware of it. With an estimated 9.6 million cases of TB each year, the convergence of the two diseases threatens to become a major public health crisis.

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