Modern Examination of Tuberculosis-Diabetes Comorbidity
Main Article Content
Abstract
Tuberculosis-diabetes co-morbidity (TB-DM) has been a hurdle in the elimination of tuberculosis worldwide. Individuals with Type 2 diabetes mellitus (T2DM) can become vulnerable to bacterial infections, due to compromised cell mediated immunity [1, 2]. Therefore, individuals with diabetes are at an increased risk for developing an active tuberculosis (TB) disease when infected with Mycobacterium tuberculosis (Mtb). It is estimated that these individuals with T2DM are about three times more likely to develop the active TB compared to individuals without diabetes. Approximately 10% of all TB cases are linked to diabetes and the risk of death from TB is roughly double for those with diabetes, especially in middle to low-income areas [3, 4]. Patients with both T2DM and TB have worse outcomes, including slower bacteria conversion, lower rate of cure, higher chances to relapse, increased risk of mortality, and even escalated drug resistance. While it is known that diabetes causes immune dysfunction, there are still many questions as to how diabetes worsens TB outcomes. It is reported that diabetes might change the appropriate mechanisms of immunological factors that maintain host immune defenses towards infectious agents, the production of specific cytokines, increased formation of reactive oxygen species, as well as reduced levels of the antioxidant glutathione (GSH). In this review, we explore recent research that helps explain the reasons for tuberculosis-diabetes (TB-DM) comorbidity as well as the possible causes for the increased risk of mortality and finally possible prophylactic treatments.
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How to Cite
VENKETARAMAN, Vishwanath et al.
Modern Examination of Tuberculosis-Diabetes Comorbidity.
Medical Research Archives, [S.l.], v. 5, n. 12, dec. 2017.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/1613>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v5i12.1613.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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3 Narasimhan P, Wood J, MacIntyre C.R, Mathai D, Risk factors for tuberculosis, Pulm. Med. 2013 (2013)
4 Benoit, S.R., et al., Association of Diabetes and Tuberculosis Disease among US-Bound Adult Refugees, 2009-2014. Emerg Infect Dis, 2017. 23(3): p. 543-545.
5 Tuberculosis (TB). World Health Organization. World Health Organization, n.d. Web. 4 November 2016.
6 Lienhardt C, Fielding K, Sillah JS, Bah B, Gustafson P, et al. Investigation of the risk factors for tuberculosis: A case-control study in three countries in West Africa. Int J Epidemiol. 2005;34:914–923.
7 Ponce-De-Leon A, Garcia-Garcia Md Mde L, Garcia-Sancho MC, Gomez-Perez FJ, Valdespino-Gomez JL, et al. Tuberculosis and diabetes in southern Mexico. Diabetes Care. 2004;27:1584–1590.
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9 Alisjahbana B, van Crevel R, Sahiratmadja E, den Heijer M, Maya A, et al. Diabetes mellitus is strongly associated with tuberculosis in Indonesia. Int J Tuberc Lung Dis. 2006;10:696–700.
10 Perez A, Brown HS, 3rd, Restrepo BI. Association between tuberculosis and diabetes in the Mexican border and non-border regions of Texas. Am J Trop Med Hyg. 2006;74:604–611.
11 Diabetes. World Health Organization. World Health Organization, n.d. Web. 7 October 2016.
12 Center for Disease Control (2014) National Diabetes Statistics Report
13 Prada-Medina, Cesar A., et al. “Systems Immunology of Diabetes-Tuberculosis Comorbidity Reveals Signatures of Disease Complications.” Scientific Reports, vol. 7, no. 1, 2017.
14 Abdul Hashim K., and Muhammed Anas Ayoob. “Impact of diabetes mellitus on clinical presentation and treatment response of smear positive pulmonary tuberculosis patients.” International Journal of Research in Medical Sciences, www.msjonline.org/index.php/ijrms/article/view/2918/2690. Accessed 26 Aug. 2017.
15 Patel, Anandk, et al. “Radiological presentation of patients of pulmonary tuberculosis with diabetes mellitus.” Lung India, vol. 28, no. 1, 2011, p. 70.
16 Chiang CY, Lee JJ, Chien ST, Enarson DA, Chang YC, et al. Glycemic control and radiographic manifestations of tuberculosis in diabetic patients. PLoS One. 2014;9(4):e93397.
17 Huang LK, Wang HH, Lai YC, Chang SC. The impact of glycemic status on radiological manifestations of pulmonary tuberculosis in diabetic patients. PLoS One. 2017;12(6):e0179750.
18 Mahishale V, Avuthu S, Patil B, Lolly M, Eti A, et al. Effect of Poor Glycemic Control in Newly Diagnosed Patients with Smear-Positive Pulmonary Tuberculosis and Type-2 Diabetes Mellitus. Iran J Med Sci. 2017 Mar;42(2):144-151.
19 Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis. 2009 Dec;9(12):737-46.
20 Lee KS, Song KS, Lim TH, Kim PN, Kim IY, et al. Adult-onset pulmonary tuberculosis: findings on chest radiographs and CT scans. AJR Am J Roentgenol. 1993 Apr;160(4):753-8.
21 Saiki O, Negoro S, Tsuyuguchi I, Yamamura Y. Depressed immunological defence mechanisms in mice with experimentally induced diabetes. Infect Immun. 1980 Apr;28(1):127-31.
22 Magee MJ, Kempker RR, Kipiani M, Gandhi NR, Darchia L, et al. Diabetes mellitus is associated with cavities, smear grade, and multidrug-resistant tuberculosis in Georgia. Int J Tuberc Lung Dis. 2015 Jun;19(6):685-92.
23 Siddiqui AN, Khayyam KU, Sharma M. Effect of Diabetes Mellitus on Tuberculosis Treatment Outcome and Adverse Reactions in Patients Receiving Directly Observed Treatment Strategy in India: A Prospective Study. Biomed Res Int. 2016;2016:7273935.
24 Riza, Anca Lelia, et al. “Clinical management of concurrent diabetes and tuberculosis and the implications for patient services.” The Lancet Diabetes & Endocrinology, vol. 2, no. 9, 2014, pp. 740–753.
25 Degner, Nicholas R, et al. The Effect of Diabetes and Comorbidities on Tuberculosis Treatment Outcomes. 2017, www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2017.195.1_MeetingAbstracts.A7587. Accessed 26 Aug. 2017.
26 Kang YA, Kim SY, Jo KW, Kim HJ, Park SK, et al. Impact of diabetes on treatment outcomes and long-term survival in multidrug-resistant tuberculosis. Respiration. 2013;86(6):472-8.
27 Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, et al. The impact of diabetes on tuberculosis treatment outcomes: a systematic review. BMC Med. 2011 Jul 1;9:81.
28 Fisher-Hoch SP, Whitney E, McCormick JB, Crespo G, Smith B, et al. Type 2 diabetes and multidrug-resistant tuberculosis. Scand J Infect Dis. 2008;40(11-12):888-93. PubMed PMID: 18728934; NIHMSID: NIHMS205077; PubMed Central PMCID
29 Gómez-Gómez A, Magaña-Aquino M, López-Meza S, Aranda-Álvarez M, Díaz-Ornelas DE, et al. Diabetes and Other Risk Factors for Multi-drug Resistant Tuberculosis in a Mexican Population with Pulmonary Tuberculosis: Case Control Study. Arch Med Res. 2015 Feb;46(2):142-8.
30 Workneh MH, Bjune GA, Yimer SA. Diabetes mellitus is associated with increased mortality during tuberculosis treatment: a prospective cohort study among tuberculosis patients in South-Eastern Amahra Region, Ethiopia. Infect Dis Poverty. 2016 Mar 21;5:22.
31 Alisjahbana B, Sahiratmadja E, Nelwan EJ, Purwa AM, Ahmad Y, et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis. 2007 Aug 15;45(4):428-35.
32 Gil-Santana L, Almeida-Junior JL, Oliveira CA, Hickson LS, Daltro C, et al. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study. PLoS One. 2016;11(1):e0146876.
33 Restrepo BI, Fisher-Hoch SP, Crespo JG, Whitney E, Perez A, et al. Type 2 diabetes and tuberculosis in a dynamic bi-national border population. Epidemiol Infect. 2007 Apr;135(3):483-91.
34 Chiang CY, Bai KJ, Lin HH, Chien ST, Lee JJ, et al. The influence of diabetes, glycemic control, and diabetes-related comorbidities on pulmonary tuberculosis. PLoS One. 2015;10(3):e0121698.
35 Leung CC, Lam TH, Chan WM, Yew WW, Ho KS, et al. Diabetic control and risk of tuberculosis: a cohort study. Am J Epidemiol. 2008 Jun 15;167(12):1486-94.
36 Park SW, Shin JW, Kim JY, Park IW, Choi BW, et al. The effect of diabetic control status on the clinical features of pulmonary tuberculosis. Eur J Clin Microbiol Infect Dis. 2012 Jul;31(7):1305-10.
37 Gomez, D.I., et al., Reduced Mycobacterium tuberculosis association with monocytes from diabetes patients that have poor glucose control. Tuberculosis (Edinb), 2013. 93(2): p. 192-7.
38 Lee, P.H., et al., Glycemic Control and the Risk of Tuberculosis: A Cohort Study. PLoS Med, 2016. 13(8): p. e1002072.
39 Komura, T., et al., CD14+ monocytes are vulnerable and functionally impaired under endoplasmic reticulum stress in patients with type 2 diabetes. Diabetes, 2010. 59(3): p. 634-43.
40 Kornfeld, H., et al., High Prevalence and Heterogeneity of Diabetes in Patients With TB in South India: A Report from the Effects of Diabetes on Tuberculosis Severity (EDOTS) Study. Chest, 2016. 149(6): p. 1501-8.
41 Workneh, M.H., G.A. Bjune, and S.A. Yimer, Prevalence and Associated Factors of Diabetes Mellitus among Tuberculosis Patients in South-Eastern Amhara Region, Ethiopia: A Cross Sectional Study. PLoS One, 2016. 11(1): p. e0147621.
42 Erol A. Visceral adipose tissue specific persistence of Mycobacterium tuberculosis may be reason for the metabolic syndrome. Medical hypotheses. 2008;71(2):222-228.
43 Cabana VG, Siegel JN, Sabesin SM. Effects of the acute phase response on the concentration and density distribution of plasma lipids and apolipoproteins. Journal of lipid research. 1989;30(1):39-49.
44 Deniz O, Gumus S, Yaman H, et al. Serum total cholesterol, HDL-C and LDL-C concentrations significantly correlate with the radiological extent of disease and the degree of smear positivity in patients with pulmonary tuberculosis. Clinical biochemistry. 2007;40(3-4):162-166.
45 Kozarevic D, McGee D, Vojvodic N, et al. Serum cholesterol and mortality: the Yugoslavia Cardiovascular Disease Study. American journal of epidemiology. 1981;114(1):21-28.
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