Review - THE DIABETES-TUBERCULOSIS CO-EPIDEMIC: THE INTERACTION BETWEEN INDIVIDUAL AND SOCIO-ECONOMIC RISK FACTORS - ABSTRACT
Authors: Adela-Gabriela Firănescu 1,2, Adina Popa 1, Maria-Magdalena Roşu 1,2, Diana Cristina Protasiewicz 1,2, Simona Georgiana Popa 1,2, Mihai Ioana 2, Maria Moța 1,2
1 Department of Diabetes, Nutrition and Metabolic Diseases, Clinical County Emergency Hospital, Craiova, Romania
2 University of Medicine and Pharmacy, Craiova, Romania
Worldwide, tuberculosis (TB) is a major cause of morbi-mortality, about 30% of the population having a Mycobacterium tuberculosis infection. Patients with diabetes mellitus (DM) have a threefold increased risk of developing the disease. The prevalence of DM is rapidly increasing, especially in countries with low and middle income, where TB incidence is also increased, thus baffling the efforts for TB control. The DM-TB coepidemic is more frequent in married, older men, with reduced level of education, low income, without a steady job, with lifestyle habits such as alcohol consumption, smoking sedentarism, living in an urban environment, in crowded areas, in insanitary conditions. These patients have a higher body mass index (BMI) compared with those without DM and frequently present family history of TB, family history of DM, longer duration of DM and reduced glycemic control. TB associated with DM is usually asymptomatic, more contagious, multidrug resistant and is significantly associated with an increased risk of therapy failure, relapse and even death. Thus, the DM-TB comorbidity represents a threat to public health and requires the implementation of urgent measures in order to both prevent and manage the two diseases.
Key words: diabetes mellitus, tuberculosis, risk factors