Call for action against ‘twin scourge’ of diabetes and TB

By Jane DreaperHealth correspondent, BBC News
3 November 2015

More needs to be done to tackle a dual threat of patients having both tuberculosis (TB) and diabetes, global health experts say.

A declaration made at a summit in Indonesia warns that the convergence of the two illnesses represents a “looming co-epidemic”. The statement calls for greater co-ordination in testing and treating diabetes and TB. Experts say progress in this area has not been fast enough.

Six countries projected to have significant numbers of diabetes patients – China, India, Brazil, Indonesia, Pakistan and Russia – are also classed as having a high burden of TB. Diabetes weakens the immune system and triples the risk of people developing TB. Patients also respond less well to TB treatment and are more likely to have the infection recur.

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Image copyright SCIENCE PHOTO LIBRARY
Image captionThe bacteria that cause TB infect the lungs and can be spread to other people by coughs and sneezes

Gangrene

Prof Anthony Harries, from the International Union Against TB and Lung Disease (The Union), said: “There’s evidence that if we treat diabetes and TB, we reduce the risk of these poor outcomes”. “In India, for example, there’s a national policy for TB patients to be screened for diabetes. “But it’s only been implemented in a couple of southern states. “The TB world tends to have good monitoring systems – and they are already used to giving people blood tests for HIV.

“Many people with diabetes don’t know they have it, so this is one small way of identifying some of them. “We have more work to do to persuade diabetes doctors to screen for TB. “They don’t always perceive it as a huge issue, because they are more worried about eye problems and gangrene. “The general situation is better than five years ago, when nothing was being done.

“But we still need more action. I’m confident and optimistic this will happen.”

Dual threat

A document launched in 2011 by The Union and the World Health Organization says TB patients should be screened for diabetes. It also calls for diabetics to be screened if they live in countries which have a high burden of TB. This is defined as more than 100 cases of TB per 100,000 of the population – which is the case in some London boroughs.

Anders Dejgaard, who runs the World Diabetes Foundation which also signed the declaration, said: “Healthcare systems must prepare to deal with this challenge”. “It is most severe in low and middle-income countries”. “We need to ensure that healthcare professionals are equipped to diagnose and take care of these two diseases as they increasingly appear together in the same patients.”

The declaration was made at a meeting in Bali which aims to highlight the dual threat, ahead of a conference about TB in Cape Town next month. Data from an Indian initiative was presented, showing that out of 52,000 people screened in the past year, a quarter who had TB also tested positive for diabetes.

 

Source : http://www.bbc.com/news/health

 

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