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TB Management

TB and Diabetes

The link between tuberculosis and diabetes

Diabetes, which causes immunosuppression, is increasingly being recognized as an independent risk factor for tuberculosis (TB) (1).

The synergistic relationship between tuberculosis (TB) and diabetes mellitus (DM) has long been recognized by clinicians (1). Data suggest that the relationship is causal – primarily emerging through hyperglycemia and its impact on immune defenses (2).

Infographic, Immune response, tuberculosis and diabetes, The link between tuberculosis and diabetes, illustration

The CDC recommends IGRA tests for TB infection

QFT-Plus, QuantiFERON-TB Gold Plus, blood draw, nurse, patient, tubes

The Centers for Disease Control and Prevention (CDC) states that someone with untreated latent TB infection and diabetes is more likely to develop TB disease than someone without diabetes (6). The development of TB in diabetes patients can be prevented by actively screening for and treating LTBI.

The CDC, ATS and IDSA preferentially recommend TB blood testing (IGRA) for the majority of the U.S. testing population (7).

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References:
1. Yorke, E., Atiase, Y., Akpalu, J., Sarfo-Kantanka, O., Boima, V., & Dey, I. D. (2017). The Bidirectional Relationship between Tuberculosis and Diabetes Tuberc Res Treat. 2017, 1702578.
2. Kapur, A., Harries, A.D. (2013) Cohort monitoring - as a tool to improve diabetes care services. Diabetes Res. Clin. Pract. 102, 260.
3. Centers for Disease Control and Prevention. (2020) National Diabetes Statistics Report. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
4. Centers for Disease Control and Prevention. (2020) Latent Tuberculosis Infection: A Guide for Primary Health Care Providers. https://www.cdc.gov/tb/publications/ltbi/pdf/LTBIbooklet508.pdf
5. van Crevel, R., & Critchley, J. A. (2021). The Interaction of Diabetes and Tuberculosis: Translating Research to Policy and Practice. Trop Med Infect Dis. 6, 8.
6. Centers for Disease Control and Prevention. TB ad Diabetes. https://www.cdc.gov/tb/topic/basics/tb-and-diabetes.html (accessed January 6, 2022)
7. Lewinsohn, D.M. et al. (2017) Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clin Infect Dis. 64, 111-115.
QFT -Plus is an in vitro diagnostic aid for detection of Mycobacterium tuberculosis infection. QFT-Plus is an indirect test for M. tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography, and other medical and diagnostic evaluations. QFT-Plus Package Inserts, available in multiple languages, as well as up-to-date licensing information and product-specific disclaimers can be found at www.QuantiFERON.com.