November 14th every year is the United Nations Diabetes Day. This year’s publicity theme is: “Understand the risks, understand the responses.” Today, we will introduce to diabetes lovers a pair of “brothers in need” who once became sworn brothers in the “Sugar Garden”. Every day, you think about launching a “sugar core war” in your body. They are tuberculosis and diabetes.
Xu Jing, deputy chief physician of the Tuberculosis Clinic of the Beijing Center for Disease Control and Prevention, reminded people with diabetes that patients with diabetes are more likely to develop active tuberculosis, and active tuberculosis, as an infectious factor, can aggravate diabetes and make it difficult for diabetic patients to control their blood sugar.
Diabetes is more likely to cause tuberculosis
Why is diabetes related to tuberculosis? Xu Jing introduced that on the one hand, diabetic patients have disorders of fat and protein metabolism in addition to disorders of glucose metabolism, leading to malnutrition and reduced body resistance. Diabetic patients have disordered sugar and fat metabolism. Excessive sugar, glycerol and ketone bodies provide energy sources for the growth and reproduction of tuberculosis bacteria. They also weaken the function of mononuclear phagocytes and further reduce the body’s immunity.
On the other hand, multiple vitamin deficiencies in diabetic patients, especially vitamin A deficiency, can lead to a decrease in the defense function of the respiratory mucosa, making it easier for tuberculosis bacteria to colonize and grow.
“Gluco-nucleus teaming up” makes treatment even more difficult
Once diabetes and tuberculosis join forces, it will be even more difficult to control the two diseases. Xu Jing explained that the symptoms of tuberculosis poisoning can cause patients with latent diabetes, borderline diabetes, and abnormal glucose tolerance to develop into clinical diabetes, aggravate diabetes, and even induce diabetic ketoacidosis.
Some anti-tuberculosis drugs may interfere with glucose metabolism and cause blood sugar instability. For example, some anti-tuberculosis drugs can cause blood sugar to rise, and some anti-tuberculosis drugs can cause blood sugar to drop. Some anti-tuberculosis drugs will accelerate the inactivation of anti-diabetic drugs, reduce the anti-diabetic effect, and lead to an increase in blood sugar.
At the same time, some anti-tuberculosis drugs can aggravate the chronic complications of diabetes. For example, some drugs may aggravate diabetic peripheral neuritis, some drugs may aggravate diabetic retinopathy, and some drugs may aggravate diabetic nephropathy or even induce renal failure.
Not only that, diabetes increases the risk of drug resistance in tuberculosis patients, making tuberculosis treatment more difficult.
People with diabetes should be screened for tuberculosis as soon as possible if they have this symptom.
How can people with diabetes prevent “sugar core collusion”? First of all, diabetic patients should go to an endocrinologist for treatment, follow the doctor’s advice, use hypoglycemic drugs rationally, control their diet, exercise appropriately, and strive to control blood sugar to reach the target to reduce the damage caused by diabetes to the body. At the same time, we must strengthen self-protection measures and try to avoid prolonged activities in poorly ventilated and crowded places. Once we find tuberculosis patients around us, we must strengthen isolation and wear masks to reduce the risk of tuberculosis infection.
In addition, diabetic patients should pay attention to self-monitoring and regular physical examinations, including chest X-rays or chest CT examinations, to detect tuberculosis early. Especially when suspicious symptoms of tuberculosis occur, such as cough and sputum for ≥2 weeks or blood in the sputum, fever, night sweats, and unexplained weight loss, you should be highly suspicious of tuberculosis and seek medical attention promptly to achieve early diagnosis and treatment. Minimize damage to health and reduce the spread of TB in health care facilities and communities.
It should be reminded that after screening, diabetic patients may consider receiving preventive anti-tuberculosis treatment if they do not suffer from tuberculosis but only have latent tuberculosis infection, which can effectively reduce the risk of tuberculosis.
Tuberculosis patients should not forget to screen for diabetes
Tuberculosis patients who actively perform diabetes screening can detect diabetes early and provide timely optimal treatment and health education. Good blood sugar control can improve the treatment effect of tuberculosis and reduce the risk of tuberculosis recurrence.
Adult patients with active tuberculosis should be screened for diabetes, especially those aged ≥40 years, overweight or obese, with a family history of diabetes, previous preclinical diabetes, a history of gestational diabetes, or a history of macrosomia. Diabetes screening items include: fasting blood glucose, glucose tolerance test, glycated hemoglobin, etc. When conditions permit, a glucose tolerance test should be performed as much as possible.
Xu Jing reminded the public that the joint battle between tuberculosis and diabetes is impossible to prevent. We must pay attention to the two-way screening and prevention of diabetes and tuberculosis, early detection, early treatment, and early benefits.Text/Reporter Li Jie