The re-emerging association between tuberculosis and diabetes: Lessons from past centuries

The association between tuberculosis (TB) and diabetes mellitus (DM) had a common place in the literature up to the first half of the 20th century, but virtually disappeared with the discovery of insulin to treat DM and antibiotics to cure TB. In the late 1990s the literature began to re-emerge with...

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Veröffentlicht in:Tuberculosis (Edinburgh, Scotland) Scotland), 2019-05, Vol.116, p.S89-S97
Hauptverfasser: Cadena, Jose, Rathinavelu, Selvalakshmi, Lopez-Alvarenga, Juan C., Restrepo, Blanca I.
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container_end_page S97
container_issue
container_start_page S89
container_title Tuberculosis (Edinburgh, Scotland)
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creator Cadena, Jose
Rathinavelu, Selvalakshmi
Lopez-Alvarenga, Juan C.
Restrepo, Blanca I.
description The association between tuberculosis (TB) and diabetes mellitus (DM) had a common place in the literature up to the first half of the 20th century, but virtually disappeared with the discovery of insulin to treat DM and antibiotics to cure TB. In the late 1990s the literature began to re-emerge with the worldwide increase in type 2 DM, particularly in TB-endemic countries. Today, type 2 DM is the most prevalent comorbidity among TB patients and the World Health Organization considers it a threat to TB control. We summarize the literature on TB and DM up to the 1960s. Then we evaluate unique aspects of this comorbidity in older times, such as the frequent diabetic comas that suggest challenges for proper DM management as insulin was being implemented, or the absence of antibiotics to cure TB. Despite the unique aspects of each study period, the literature across times is consistent in key aspects of the association. Namely, a higher TB prevalence among DM (versus non-DM patients), the importance of glucose control and chronic DM on TB susceptibility and the higher risk of death among patients with the co-morbidity. From the older literature, we can infer the likely contribution of type 1 DM to TB (in addition to type 2), regardless of their differing autoimmune or metabolic pathophysiology, respectively. Furthermore, in the older literature there was a notable reporting of DM development among TB patients, even though DM usually preceded TB. This observation deserves further epidemiological and basic studies to elucidate this intriguing aspect of the relationship between TB and DM.
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In the late 1990s the literature began to re-emerge with the worldwide increase in type 2 DM, particularly in TB-endemic countries. Today, type 2 DM is the most prevalent comorbidity among TB patients and the World Health Organization considers it a threat to TB control. We summarize the literature on TB and DM up to the 1960s. Then we evaluate unique aspects of this comorbidity in older times, such as the frequent diabetic comas that suggest challenges for proper DM management as insulin was being implemented, or the absence of antibiotics to cure TB. Despite the unique aspects of each study period, the literature across times is consistent in key aspects of the association. Namely, a higher TB prevalence among DM (versus non-DM patients), the importance of glucose control and chronic DM on TB susceptibility and the higher risk of death among patients with the co-morbidity. 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subjects Animals
Comorbidity
Death
Diabetes Mellitus, Type 1 - diagnosis
Diabetes Mellitus, Type 1 - epidemiology
Diabetes Mellitus, Type 1 - history
Diabetes Mellitus, Type 1 - mortality
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - history
Diabetes Mellitus, Type 2 - mortality
History
History, 19th Century
History, 20th Century
History, 21st Century
Humans
Incidence
Prevalence
Prognosis
Risk Assessment
Risk Factors
Time Factors
Treatment outcomes
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis - epidemiology
Tuberculosis - history
Tuberculosis - mortality
Type 1 diabetes
Type 2 diabetes
title The re-emerging association between tuberculosis and diabetes: Lessons from past centuries
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