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Background: Tuberculosis (TB) and Diabetes mellitus (DM) are the important recent upcoming
health issues. Tuberculosis is the most common risk factor associated with DM. TB has an especially
high prevalence in diabetes patients, in whom it is usually asymptomatic and are more likely to
result in drug-resistant tuberculosis TB is also the third cause of death due to non-communicable
disease (NCD). TB has been associated with increased rates in DM of which may be partially
explained by a blunted T cell–mediated immune response. Infection caused by mycobacterium that
usually have the glycolipid lipoarabinomannan (LAM), soluble TB factor and lipo peptid, are
recognized by receptors on host cells. Aim of the study: To perform a review to summarize evidence
for the impact of tuberculosis on diabetes outcomes.
The Impact of Diabetes on TB: The Pathophysiology of tuberculosis is multiple complex.
Acquisition of the infection is primarily dependent on exogenous factors however, reactivation of
disease is largely under the influence of immune sufficiency .1The WHO has identified DM as a
global epidemic, Mostly affecting low and middle income countries where 80% of all deaths due to
DM, about 10% of global TB cases are linked to diabetes .Simultaneously, TB continues to be a
major cause of death worldwide despite the fact that the epidemic appears to be on the verge of
declining. The global burden of disease due to DM and TB is immense. in 2010, there were an
estimated 285 million people living with DM. In 2011, the International Diabetes Federation (IDF)
estimated that about 366 million people worldwide had DM, a number which is expected. To grow to
at least 439 million by the year 2030, with approximately 4 million deaths. Eighty percent (80%) of
these people live in low and middle income countries where tuberculosis (TB) is highly prevalent. In
2007, there were an estimated 14.4 million people living with TB, 9.2 million new cases and1.7
million deaths (WHO 2009). The risk of progression from exposure to the TB bacilli to the
development of active disease is a two-stage process governed by both exogenous and endogenous
risk factors. Exogenous factors play a key role in accentuating the progression from exposure to
infection among which the bacillary load in the sputum and the proximity of an individual to an
infectious TB case are key factors. Similarly endogenous factors lead in progression from infection
to active TB disease. The key risk factors are: 1) Factors related to the index case 2) Factors related
to the individual 3) Socioeconomic and behavioral factors 4) Demographic (ethnic) factors and 5)
Health System Issues
Key words: Tuberculosis (TB). Type 2 Diabetes mellitus (DM), Low socio economic status