In the past 25 years, managing the co-epidemics of HIV and tuberculosis has presented an enormous challenge for health systems in low- and middle-income countries. In the 21st century, a new kind of co-epidemic is looming, created by the dramatically increasing number of people with diabetes.

 

Global data shows that diabetes increases the risk of tuberculosis by a factor of 2-3. With an estimated 285 million diabetic patients worldwide in 2010 and the number predicted to grow to 440 million by 2030, the diabetes epidemic threatens to cause an escalation in TB incidence as well as complicate the management of the disease.

 

The Union's experts in tuberculosis and non-communicable diseases began to address this challenge back in 2008, and are actively looking at interventions to reduce the dual burden of disease. In 2010, they held a seminar and training session in China, home to 90 million diabetics and some 150 million pre-diabetics, on how best to carry out bi-directional screening of tuberculosis among patients with diabetes and blood glucose testing in patients with tuberculosis.

Diabetes challenges

• In 2010, an estimated 285 million people live with diabetes (6.4% of the adult population).
• 70% of cases occur in low- and middle-income countries.
• In these countries, less than ½ of the cases are diagnosed.
• The cost for diabetes treatment for 1 person is 75% of the per capita income in Mozambique, 61% in Mali, 51% in Vietnam.
• Diabetes increases the risk of tuberculosis by a factor of 2-3.

Source: Diabetes Atlas (4^th ed)