High sugar levels attract the deadly tuberculosis bacteria. A year-long study conducted by the Brihanmumbai Municipal Corporation (BMC) unearthed a harrowing co-infection trend between the poor man's disease TB and diabetes, which is more likely to strike the affluent class.
Of 13,466 tuberculosis patients screened in Mumbai between January to December last year, 1,022 patients tested positive for diabetes. "The prevalence of diabetes in Mumbai's TB patients is 7.5%. We are screenings all TB patients for diabetes. Seventy-six TB dispensaries in Mumbai ensure management of diabetes for TB patients," said Dr Minni Khetarpal, TB officer, BMC.
A study by Stevenson et al in 2007 has quoted that a diabetic patient is three times more likely to get TB than a person who does not have diabetes.
Experts contend that it is high time the government started providing free diabetes treatment to TB patients since many of them cannot afford the cost of insulin. "While TB treatment is covered in the Centre's Revised National TB Control Programme, TB patients bleed financially because of the high cost of insulin. It is high time that government starts giving importance to diabetes and TB just like TB and HIV co-infection is being tackled in unison," said Dr Prabhudesai, chest physician at Lilavati hospital.
Doctors from private-run PD Hinduja hospital in Mahim had written in a recent medical journal expressing their concern between the deadly confluence of the poor man and the rich man's diseases.
Dr Roshani Sanghani, diabetologist and Dr Zarir Udwadia, chest physician, at PD Hinduja hospital, say in the article: "We are approaching a day and age where the terms communicable and non-communicable diseases are taking on a new meaning. In our practice, we have seen a growing link between TB and diabetes and think that we need to do more research on the same."
Dr P Prabhudesai said, "I have diabetes patients diagnosed with multi-drug resistant TB (MDR-TB) and it becomes very difficult to manage both these diseases." He said that the effect of TB drugs rolls into patients getting uncontrolled diabetes. They then have to be put on expensive insulin treatment to control their sugar levels.
Opposing drugs cause havoc in the co-infected patient's body. "Drug interactions between oral hypoglycemic diabetes drugs and rifampicin, a TB drug, cause the concentration of both drugs to dip in the patient's body. There is a high risk of liver failure as the toxicity levels in a TB-diabetes co-infected patient are very high," said Dr Anthony Harries, senior advisor, International Union Against TB and Lung Diseases.
High rate of infection
India has close to 25 lakh TB patients of which 13% are reported to be diabetics.
Of 13,466 tuberculosis patients screened in Mumbai last year, 1,022 patients tested positive for diabetes. The prevalence of diabetes in Mumbai's TB patients is 7.5%.
A study by Stevenson et al in 2007 has quoted that a diabetic patient is three times more likely to get TB than a person who does not have diabetes.
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