The Complex Relationship Between Tuberculosis and Hyperglycemia

Authors

Michelle Byers
Elizabeth Guy

Publication Date

11-13-2024

Journal

Diagnostics

DOI

10.3390/diagnostics14222539

PMID

39594205

PMCID

PMC11593071

PubMedCentral® Posted Date

11-13-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

tuberculosis, hyperglycemia, diabetes, pre-diabetes, intermediate hyperglycemia

Abstract

Hyperglycemia and tuberculosis are dual global pandemics. Each has a propulsive and amplifying effect on the other, and, because of this, we must consider hyperglycemia and tuberculosis together. Hyperglycemia is immunosuppressive and increases the risk of tuberculosis by threefold. It also leads to a more advanced presentation of pulmonary tuberculosis, thus increasing the likelihood of being smear positive and having cavitating lesions, and it impacts the duration and outcomes of treatment, with an increased one year mortality seen in patients with tuberculosis and diabetes. Additionally, any degree of hyperglycemia can have an impact on susceptibility to tuberculosis, and this effect is not limited to poorly controlled diabetes. Conversely, tuberculosis itself is associated with hyperglycemia and worsens hyperglycemia in those with diabetes mellitus. The impact of this relationship varies based on the base rates of each disease in different regions of the world. In order to successfully achieve the World Health Organization's goals of tuberculosis eradication and adequate glycemic control, we must improve our understanding, co-management, and screening of hyperglycemia and tuberculosis. This review aims to explore the current research investigating the relationship between tuberculosis and diabetes, including the changes in disease susceptibility, presentation, geographic distribution, and effects on treatment.