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Gamaniuc Marina

Author: Gamaniuc Marina, laboratory physician

Tuberculosis is a major public health problem with approximately 10 million new cases reported worldwide each year and 1.8 million deaths annually. Tuberculosis ranks first among infectious disease deaths worldwide. According to the World Health Organization (WHO), the Republic of Moldova is among the 18 countries in the European Region where tuberculosis control is a priority and among the 27 countries worldwide with a high burden of multidrug-resistant tuberculosis (TB RR/MDR). Diabetes mellitus (DM) is a major risk factor for developing tuberculosis. Globally, approximately 15% of pulmonary TB cases are associated with diabetes mellitus. In populations exposed to tuberculosis (TB), diabetes mellitus can significantly contribute to the increased incidence of TB. Moreover, TB/DM cases have a higher likelihood of late diagnosis, unfavorable prognosis, and increased mortality.

Recently, the WHO and the International Union Against Tuberculosis and Lung Disease recognized the need for international guidelines for the joint management and control of tuberculosis and diabetes mellitus. They have published a provisional framework for collaboration in the care and control of both diseases. Many studies have shown that the prevalence of tuberculosis among patients with diabetes mellitus is 2-5 times higher than in the non-diabetic population.

Some studies have indicated that 10-30% of TB patients may have diabetes mellitus. Previously, diabetes mellitus was known as a risk factor for TB; however, with the improvement in the treatment of both diseases, few studies have been conducted on the association between TB/DM. This issue needs to be analyzed, considering the high rate of type 2 diabetes mellitus in developing countries where tuberculosis is endemic.

It should be noted that the severity of pulmonary tuberculosis increases the risk of diabetes mellitus, creating a significant negative impact on public health, especially in countries where both diseases are highly endemic.