To mark World Diabetes Day, The Union and the World Diabetes Foundation have released a short documentary film that tells the stories of Vijay, Amitabh, and Kavita — three people in India living with TB-diabetes — the challenges they face, and the solutions that we can put into action to stop the co-epidemic.
In one of the most complex public health challenges of the new century, the global rise in type 2 diabetes is driving the spread of tuberculosis — an airborne, infectious disease caused by a bacterial infection. Based on high rates of diabetes documented among TB patients in such diverse settings from India to China to the United States, public health scientists and experts are now warning of a public health “perfect storm”: an epidemic of TB-diabetes.
“Those with diabetes are at far higher risk of contracting TB, present more difficulties when being treated for it, and may contribute to the infection’s spread.” — Financial Times, 13 November 2014
Tuberculosis kills more people than any other single infectious disease in the world. Nearly five thousand people die from tuberculosis per day.
Tuberculosis is an airborne disease. TB bacteria spread when somebody sick with tuberculosis coughs, sneezes, or even sings — and somebody else then inhales the bacteria, which leads to infection. TB infection can stay in the body for weeks, months, even years without making the person sick. The risk of living with TB infection is that at some future point the infection can develop into an active disease: tuberculosis. This risk increases significantly when the person is experiencing another illness that weakens the immune system.
Because of these two diseases I had to leave my job, and now I cannot go out to earn money for my family’s livelihood. — Amitabh Pandey
Diabetes weakens a person’s immune system, tripling the risk of developing tuberculosis. In countries as diverse as China, India, the United States and small island states throughout the Pacific, recent studies are already showing rates of diabetes between 16% and 45% among people diagnosed with tuberculosis.
And as countries become wealthier and societies change — people eat more meat, they adopt more sedentary lifestyles — rates of diabetes are going up. According to the World Diabetes Atlas, the number of people living with type 2 diabetes worldwide is on course to increase from 415 million people today to 642 million by 2040.
This massive rise in diabetes will generate more tuberculosis — especially because diabetes is increasing in countries where TB infection is common. Six out of the ten countries projected to have the greatest burdens of diabetes by 2040 are also countries that the World Health Organization classifies as “high TB burden” countries: Brazil, China, India, Indonesia, Pakistan and Russia.
Just as diabetes increases the risk of tuberculosis, successfully treating tuberculosis becomes very difficult when the person is living with unmanaged diabetes. The two diseases need to be managed carefully — a fact many doctors aren’t yet aware of — and delays in diagnosis can have tragic consequences.
During my third pregnancy, I was okay in the initial months. But then I had problems with fever and severe cough. … During the ninth month of my pregnancy, I found out my child was no longer alive in my womb. — Kavita Viswakarma
One of the most important solutions for stopping the epidemic of TB-diabetes is for TB patients to receive screening for diabetes; and in areas where there are high rates of TB, people diagnosed with diabetes should receive screening for TB.
Both diseases are deadly diseases, and when both diseases are present simultaneously, they become a more serious problem throughout the world. … We are not thinking about the linkage. We need to think about the linkage. — Dr. Tariq Mahmood, Head, Department of Pulmonology, SRN Hospital, MLN Medical College.
Countries can begin implementing a response to TB-diabetes by following the recommendations in the Collaborative Framework for Care and Control of Tuberculosis and Diabetes.
When HIV/AIDS — another disease that harms the immune system — began spreading in the 1980s, tuberculosis skyrocketed in countries hardest hit by HIV. The co-epidemic of tuberculosis and HIV led to millions of deaths and became an overwhelming public health challenge to which countries are still struggling to respond. We cannot let history repeat itself in the case of tuberculosis and diabetes.
To learn more, read The Looming Co-epidemic of TB-Diabetes: A Call To Action.
