Tuberculosis And Diabetes - A Tale Of Two Epidemics

Dr Shilpa Sule and Sunila Kelkar walk you through the corridors that intersect the paths that Diabetes and Tuberculosis may follow

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Case Study 1

Mr H, a 47-year-old male chronic smoker, complained of decreased appetite, fatigue, frequent urination, excessive thirst and progressive weight loss for 6 months. He complained of cough with sputum for 3 months and mild fever intermittently. He had no past medical illness. His family history revealed that his father had Diabetes and his mother had hypertension.

Mr H was thin-built and his body weight was 50 kg. He had a temperature of 100 F, high pulse rate and blood pressure was normal. His chest examination revealed abnormal breath sounds. Laboratory investigations revealed random blood sugar level of 387 mg/dL and his HbA1c (a test that checks 3-months average blood sugar range) was 11.2 per cent. His complete blood count, liver function and renal function tests were normal. His chest X-ray was suggestive of pulmonary tuberculosis. As a next step, his sputum examination was performed which showed tubercular bacilli.

Based on the clinical symptoms and investigations, diagnosis of Diabetes and Pulmonary Tuberculosis was confirmed. He was advised isolation and started on antitubercular medication. He was started on insulin therapy for blood sugar control.

After 2 months of antitubercular treatment, his repeat sputum examination was negative for tubercular bacilli. His health got better with good glycaemic control on his follow up visits.

Take home message

Annual checking of blood sugar levels, blood pressure and lipid levels help timely diagnose and manage health problems. People with high blood sugar levels are at a high risk of developing infectious diseases such as influenza and tuberculosis (TB). Better management of blood sugar levels prevents the risk of complications or improves recovery from infections in Diabetes.