Tuberculosis Among Diabetes Patients: A Review of Epidemiology, Pathophysiology, Clinical Manifestations, and Management

Abstract

The intersection of tuberculosis (TB) and diabetes mellitus (DM) poses a significant global health challenge, with each condition exacerbating the other’s clinical course and outcomes. This review explores the epidemiological burden, pathophysiological interactions, clinical manifestations, diagnostic challenges, and treatment strategies for managing TB in patients with diabetes. Understanding the bidirectional relationship between TB and diabetes is crucial for developing effective public health interventions and clinical management guidelines to mitigate the impact of these coexisting conditions. The risk factors contributing to the co-occurrence of TB and diabetes are multifaceted, involving both biological and socio-environmental components. Chronic hyperglycemia in diabetes leads to various immune dysfunctions, such as impaired cytokine production, reduced neutrophil activity, and altered macrophage function, all of which are critical components of the body's defense against TB infection. The clinical presentation of TB in diabetic patients can be atypical and often more severe compared to non-diabetic individuals. This atypical presentation may delay diagnosis and worsen outcomes. Addressing the dual burden of TB and diabetes requires integrated care models that bring together TB and diabetes services under a unified approach. Understanding of epidemiology, pathophysiology and clinical manifestation of TB, diabetes and co-infection are necessary to understand for disease control. The intersection of TB and diabetes represents a significant public health challenge that requires urgent attention and a coordinated response. The bidirectional relationship between these two diseases exacerbates their impact, leading to higher morbidity and mortality, especially in resource-limited settings. Effective management of TB-diabetes comorbidity requires an integrated approach.