Skip to main content
SpringerLink
Log in

Diabetes und Tuberkulose

Eine kurze Übersicht

Diabetes and tuberculosis

A short review

  • Leitthema
  • Published:
Der Diabetologe Aims and scope

Zusammenfassung

Hintergrund

Tuberkulose ist weiterhin die Infektionskrankheit, an welcher weltweit die meisten Menschen versterben.

Ziel des Beitrags

Die aktuelle Literatur zur Assoziation von Diabetes und Tuberkulose wird beschrieben, und Fragen des klinischen Managements bei Patienten mit beiden Diagnosen werden diskutiert.

Ansteckungsgefahr

Das Risiko, an einer Tuberkulose zu erkranken, ist bei Patienten mit Diabetes im Vergleich zur nicht an dieser Stoffwechselerkrankung leidenden Bevölkerung verdreifacht.

Therapie von an Tuberkulose erkrankten Diabetespatienten

Die Behandlungsergebnisse bezüglich der Tuberkulose sind bei Patienten mit vs. ohne Diabetes schlechter, und sowohl die Therapie der Tuberkulose als auch die des Diabetes werden durch Medikamenteninteraktionen erschwert.

Abstract

Background

Tuberculosis continues to be the infectious disease that kills the most people worldwide.

Objective

In this article we describe the current literature on the association between diabetes and tuberculosis, and discuss issues of clinical management of concurrent diagnosis of diabetes and tuberculosis.

Risk of infection

The risk of developing tuberculosis is three times higher in patients with diabetes compared to people without diabetes.

Treatment of diabetes patients with tuberculosis

Tuberculosis treatment outcomes are worse for patients with diabetes, and care of patients with both tuberculosis and diabetes is complicated by drug interactions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. World Health Organization (2017) Global Tuberculosis Report 2017. World Health Organization, Genf

    Google Scholar 

  2. World Health Organization (2014) End TB Strategy. World Health Organization, Genf

    Google Scholar 

  3. Grillo VJ (1933) The type and distribution of pathology in pulmonary tuberculosis associated with diabetes mellitus. Yale J Biol Med 5(6):559–572

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Dooley KE, Chaisson RE (2009) Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis 9(12):737–746

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jeon CY, Murray MB (2008) Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. Plos Med 5(7):e152

    Article  PubMed  PubMed Central  Google Scholar 

  6. Al-Rifai RH, Pearson F, Critchley JA, Abu-Raddad LJ (2017) Association between diabetes mellitus and active tuberculosis: A systematic review and meta-analysis. PLoS ONE 12(11):e187967

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ponce-De-Leon A, Garcia-Garcia Md Mde L, Garcia-Sancho MC, Gomez-Perez FJ, Valdespino-Gomez JL, Olaiz-Fernandez G et al (2004) Tuberculosis and diabetes in southern Mexico. Diabetes Care 27(7):1584–1590

    Article  PubMed  Google Scholar 

  8. Lee MR, Huang YP, Kuo YT, Luo CH, Shih YJ, Shu CC et al (2017) Diabetes mellitus and latent tuberculosis infection: a systemic review and Metaanalysis. Clin Infect Dis 64(6):719–727

    PubMed  Google Scholar 

  9. Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, Lonnroth K et al (2011) The impact of diabetes on tuberculosis treatment outcomes: a systematic review. BMC Med 9:81

    Article  PubMed  PubMed Central  Google Scholar 

  10. Tegegne BS, Habtewold TD, Mengesha MM, Burgerhof JG (2017) Association between diabetes mellitus and multi-drug-resistant tuberculosis: a protocol for a systematic review and meta-analysis. Syst Rev 6(1):6

    Article  PubMed  PubMed Central  Google Scholar 

  11. Odone A, Houben RM, White RG, Lonnroth K (2014) The effect of diabetes and undernutrition trends on reaching 2035 global tuberculosis targets. Lancet Diabetes Endocrinol 2(9):754–764

    Article  PubMed  Google Scholar 

  12. Pan SC, Ku CC, Kao D, Ezzati M, Fang CT, Lin HH (2015) Effect of diabetes on tuberculosis control in 13 countries with high tuberculosis: a modelling study. Lancet Diabetes Endocrinol 3(5):323–330

    Article  PubMed  Google Scholar 

  13. Martinez N, Kornfeld H (2014) Diabetes and immunity to tuberculosis. Eur J Immunol 44(3):617–626

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Restrepo BI, Schlesinger LS (2013) Host-pathogen interactions in tuberculosis patients with type 2 diabetes mellitus. Tuberculosis (Edinb) 93(Suppl):S10–S4

    Article  CAS  Google Scholar 

  15. Handel AE, Ramagopalan SV (2010) Tuberculosis and diabetes mellitus: is vitamin D the missing link? Lancet Infect Dis 10(9):596

    Article  PubMed  Google Scholar 

  16. Wang Q, Ma A, Han X, Zhang H, Zhao S, Liang H et al (2017) Is low serum 25-hydroxyvitamin D a possible link between pulmonary tuberculosis and type 2 diabetes? Asia Pac J Clin Nutr 26(2):241–246

    PubMed  Google Scholar 

  17. Liao T‑L, Lin C‑F, Chen Y‑M, Liu H‑J, Chen D‑Y (2016) Risk factors and outcomes of Nontuberculous Mycobacterial disease among rheumatoid arthritis patients: a case-control study in a TB endemic area. Sci Rep 6:29443

    Article  PubMed  PubMed Central  Google Scholar 

  18. Alim MA, Sikder S, Bridson TL, Rush CM, Govan BL, Ketheesan N (2017) Anti-mycobacterial function of macrophages is impaired in a diet induced model of type 2 diabetes. Tuberculosis (Edinb) 102:47–54

    Article  CAS  Google Scholar 

  19. WHO (2011) Collaborative framework for care and control of tuberculosis and diabetes. WHO guidelines approved by the guidelines review committee. WHO, Genf

    Google Scholar 

  20. Maurice J (2011) WHO framework targets tuberculosis-diabetes link. Lancet 378(9798):1209–1210

    Article  PubMed  Google Scholar 

  21. Kapur A, Harries AD, Lonnroth K, Wilson P, Sulistyowati LS (2016) Diabetes and tuberculosis co-epidemic: the Bali Declaration. Lancet Diabetes Endocrinol 4(1):8–10

    Article  PubMed  Google Scholar 

  22. van Crevel R, Dockrell HM, Tandem Consortium (2014) TANDEM: understanding diabetes and tuberculosis. Lancet Diabetes Endocrinol 2(4):270–272

    Article  PubMed  Google Scholar 

  23. Jeon CY, Harries AD, Baker MA, Hart JE, Kapur A, Lonnroth K et al (2010) Bi-directional screening for tuberculosis and diabetes: a systematic review. Trop Med Int Health 15(11):1300–1314

    Article  PubMed  Google Scholar 

  24. Li L, Lin Y, Mi F, Tan S, Liang B, Guo C et al (2012) Screening of patients with tuberculosis for diabetes mellitus in China. Trop Med Int Health 17(10):1294–1301

    Article  PubMed  Google Scholar 

  25. Castellanos-Joya M, Delgado-Sanchez G, Ferreyra-Reyes L, Cruz-Hervert P, Ferreira-Guerrero E, Ortiz-Solis G et al (2014) Results of the implementation of a pilot model for the bidirectional screening and joint management of patients with pulmonary tuberculosis and diabetes mellitus in Mexico. PLoS ONE 9(9):e106961

    Article  PubMed  PubMed Central  Google Scholar 

  26. Prakash BC, Ravish KS, Prabhakar B, Ranganath TS, Naik B, Satyanarayana S et al (2013) Tuberculosis-diabetes mellitus bidirectional screening at a tertiary care centre, South India. Public Health Action 3(Suppl 1):S18–S22

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Lin Y, Li L, Mi F, Du J, Dong Y, Li Z et al (2012) Screening patients with diabetes mellitus for tuberculosis in China. Trop Med Int Health 17(10):1302–1308

    Article  PubMed  Google Scholar 

  28. Schaberg T, Bauer T, Brinkmann F, Diel R, Feiterna-Sperling C, Haas W et al (2017) S2k-Leitlinie: Tuberkulose im Erwachsenenalter. Pneumologie 71(06):325–397

    Article  PubMed  Google Scholar 

  29. Boillat-Blanco N, Ramaiya KL, Mganga M, Minja LT, Bovet P, Schindler C et al (2016) Transient hyperglycemia in patients with tuberculosis in Tanzania: implications for diabetes screening algorithms. J Infect Dis 213(7):1163–1172

    Article  CAS  PubMed  Google Scholar 

  30. Kumpatla S, Aravindalochanan V, Rajan R, Viswanathan V, Kapur A (2013) Evaluation of performance of A1c and FPG tests for screening newly diagnosed diabetes defined by an OGTT among tuberculosis patients – a study from India. Diabetes Res Clin Pract 102(1):60–64

    Article  CAS  PubMed  Google Scholar 

  31. World Health Organization (2018) Updated and consolidated guidelines for programmatic management. World Health Organization, Geneva

    Google Scholar 

  32. Chiang CY, Lee JJ, Chien ST, Enarson DA, Chang YC, Chen YT et al (2014) Glycemic control and radiographic manifestations of tuberculosis in diabetic patients. PLoS ONE 9(4):e93397

    Article  PubMed  PubMed Central  Google Scholar 

  33. Riza AL, Pearson F, Ugarte-Gil C, Alisjahbana B, van de Vijver S, Panduru NM et al (2014) Clinical management of concurrent diabetes and tuberculosis and the implications for patient services. Lancet Diabetes Endocrinol 2(9):740–753

    Article  PubMed  PubMed Central  Google Scholar 

  34. Wang JY, Lee MC, Shu CC, Lee CH, Lee LN, Chao KM et al (2015) Optimal duration of anti-TB treatment in patients with diabetes: nine or six months? Chest 147(2):520–528

    Article  PubMed  Google Scholar 

  35. Critchley JA, Restrepo BI, Ronacher K, Kapur A, Bremer AA, Schlesinger LS et al (2017) Defining a research agenda to address the converging epidemics of tuberculosis and diabetes: part 1: epidemiology and clinical management. Chest 152(1):165–173

    Article  PubMed  Google Scholar 

  36. Jørgensen ME, Faurholt-Jepsen D (2014) Is there an effect of glucose lowering treatment on incidence and prognosis of tuberculosis? A systematic review. Curr Diab Rep 14(7):505

    Article  PubMed  Google Scholar 

  37. Hossain MD, Ahmed JU, Rahim MA, Musa AKM, Latif ZA (2016) Bangladesh national guidelines on the management of tuberculosis and diabetes mellitus co-morbidity (summary). Indian J Endocrinol Metab 20(6):853–857

    Article  PubMed  PubMed Central  Google Scholar 

  38. Tornio A, Niemi M, Neuvonen PJ, Backman JT (2012) Drug interactions with oral antidiabetic agents: pharmacokinetic mechanisms and clinical implications. Trends Pharmacol Sci 33(6):312–322

    Article  CAS  PubMed  Google Scholar 

  39. Boglou P, Steiropoulos P, Papanas N, Bouros D (2013) Hypoglycaemia due to interaction of glimepiride with isoniazid in a patient with type 2 diabetes mellitus. BMJ Case Rep. https://doi.org/10.1136/bcr-2012-008528

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung Infektiologie, Klinik für Innere Medizin II, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hugstetterstr. 55, 79098, Freiburg, Deutschland

    B. Lange, A. Bockey, J. L. Z. Nyirenda & D. Wagner

  2. Centrum für Chronische Immundefizienz, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland

    B. Lange

Authors
  1. B. Lange
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Bockey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. L. Z. Nyirenda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. Lange.

Ethics declarations

Interessenkonflikt

B. Lange, A. Bockey, J.L.Z. Nyirenda und D. Wagner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lange, B., Bockey, A., Nyirenda, J.L.Z. et al. Diabetes und Tuberkulose. Diabetologe 14, 160–165 (2018). https://doi.org/10.1007/s11428-018-0327-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11428-018-0327-x

Schlüsselwörter

Keywords

Search

Navigation