TUBERCULOSISL India: TB, diabetes make for grim combo: experts call for treatment protocol
In 600 A.D., Indian physician Sushruta had said there was an association between two deadly diseases — tuberculosis and diabetes.
Today, with this association having become a dangerous reality, doctors say the need of the hour is to develop a treatment protocol for patients who have both TB and diabetes.
“When patients with tuberculosis get diabetes, there is almost no sign of it. When we followed TB patients who had diabetes, we found that their treatment for TB was failing, leading to a delay in their recovery. There is an urgent need now to screen all TB patients for diabetes. The government already screens pregnant women for diabetes, and this needs to be extended to those with TB as well,” said Vijay Viswanathan, head and chief diabetologist, M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre.
Not treating diabetes could have severe outcomes on the treatment of TB, including an increased risk of recurrent TB, he said.
Conversely, diabetics are also more vulnerable to TB. “They have a three times higher risk of contracting TB, as diabetes affects their innate and adaptive immunity,” said Soumya Swaminathan, director of the National Institute for Research in Tuberculosis.
Sometime ago, the Tuberculosis Research Centre conducted a study among 100 TB patients — 50 of whom had diabetes and 50 of those who didn’t.
“The study found excellent TB treatment outcomes when diabetes was controlled and closely monitored. There was the same cure rate and low recurrence rate,” she observed.
The emphasis now is on developing a protocol to treat people with diabetes and TB, said health secretary, J. Radhakrishnan.
“We already have a standard treatment protocol for TB and for Multi-drug-resistant (MDR) TB. With diabetes, there may be added complications and treatment may take longer.
The focus should be on case management — every TB patient should be tested for diabetes and every diabetic with symptoms of cough should be tested for TB,” he said.
The discussion on the dual burden of diabetes and TB – a consensus on treating coexisting diseases, was jointly organised by Primary Health Care Intervention Research and Education- ASPIRE and M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre.
After service in the British SAS Regiment the author became a physician and then an orthopaedic surgeon.
He has held professorial positions in Canada, Vietnam and the United States, practiced and taught orthopaedic surgery in three continents and in several wars.
He has extensive experience as an expert witness in court. Somewhere along the way, time was found to operate a four hundred acre mixed farm, a one hundred seat restaurant and to obtain a licence as a flying instructor.
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