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Tuberculosis is the leading cause of death from infection worldwide. The bacteria that causes tuberculosis infect one in every four people on the planet, though most never develop the disease. People with diabetes are more likely to develop tuberculosis and they develop more severe symptoms, which may contribute to further spread of the disease. As diabetes rates are growing worldwide, particularly in countries with a high burden of tuberculosis, it is becoming to increasingly important to understand how these two conditions interact.
People with diabetes often have more severe inflammation at the time they are diagnosed with tuberculosis than tuberculosis patients without diabetes. Inflammation can cause permanent lung damage in patients with tuberculosis, which can have serious consequences. Learning more about how treatment for tuberculosis affects inflammation in people with diabetes could help improve the outcomes for these patients.
Now, Kumar, Fukutani et al. show that people with diabetes experience higher levels of inflammation than patients without diabetes throughout the course of treatment for tuberculosis. The analysis compared 17 markers of inflammation in tuberculosis patients with and without diabetes at diagnosis, and at two time periods during the 6-month course of treatment. Kumar, Fukutani et al. also looked at two separate groups of patients, one from India and one from Brazil. Inflammation was measured in the patients in India one year after the completion of treatment. One-year after treatment for tuberculosis in India, inflammation levels were the same in patients with and without diabetes.
Persistently higher levels of inflammation likely explain why patients with diabetes experience more severe symptoms and suggests they may have more permanent lung damage after tuberculosis. Scientists are currently developing new treatments that can be used with antibiotics to more quickly cure tuberculosis and protect the lungs by reducing inflammation. Patients with diabetes and tuberculosis may benefit from these new treatments or from existing drugs like metformin or statins that may reduce inflammation.