Journal of Diabetology

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Journal of Diabetology 44 7897 074717

Diabetes And Pulmonary Tuberculosis:

The relationship between Diabetes Mellitus (DM) and consumption has attracted the interest of the many clinicians and investigators for an extended time. Many studies have shown that the prevalence of tuberculosis among diabetics is 2–5 times higher than in the nondiabetic population. Tight glycemic control may improve tuberculosis (TB) treatment outcome and helps to reduce symptoms. However, active Tuberculosis and TB treatment hamper the glycemic control. Patients starting from TB treatment experience the rapid changes in appetite, body composition, and inflammation (which increases insulin resistance); inflammation may be a feature of untreated TB and following a rise as a result of initial bacterial killing, inflammation subsides with successful treatment. In addition, for tuberculosis medication (rifampicin) increases the metabolism of oral anti-diabetic drugs including the widely used sulphonylureas and thiazolidinediones, though a possible interaction with the antidiabetic metformin has not been previously examined. Frequent monitoring of blood sugar with adjustments in anti-diabetes medication during the course of TB treatment may therefore be needed. However, frequent monitoring is related to the additional costs, and tools and skills for glucose monitoring and diabetes treatment could also be lacking in TB or pulmonary clinics, creating a requirement to refer patients to other health providers. As such, a less intense schedule, it is preferably following the established decision points in TB treatment after 2 and 6 months would offer a significant advantage. None of these issues have been addressed systematically so far.

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