Frequency of tuberculosis among diabetic patients in the People’s Republic of China

Wang, Hong-Tian; Zhang, Jing; Ji, Ling-Chao; You, Shao-Hua; Bai, Yin; Dai, Wei; Wang, Zhong-Yuan

The incidences of diabetes mellitus (DM) and tuberculosis (TB) are increasing, representing a serious threat to human longevity and health. Further, the prevalence, morbidity, mortality, and overall health hazards have increased in recent years. The number of DM patients worldwide has been estimated at about 347 million, 1 with about 7 million of those classified as new cases; additionally, up to 2008, 3.9 million people had died from DM, with 80% of the deaths occurring in low-and middleincome countries. 2 It is expected that by 2025, the number of patients with DM in India, the People's Republic of China, Pakistan, and Mexico will increase by 200%, and the number of patients with DM in India and the People's Republic of China will account for one-third of the total number of patients with DM worldwide. By 2030, the estimated number of DM patients will be about 438 million according to the current rate of growth, with 80% of new DM patients living in developing countries. Frighteningly, the World Health Organization (WHO) projects that DM will be the seventh leading cause of death by 2030. 3 The WHO declared TB a "global health emergency" in 1993, and in 2006, the Stop TB Partnership developed a global plan to stop TB that aims to save 14 million lives between its launch and 2015. 4 A number of targets they have set are not likely to be achieved by 2015, largely due to the increase in DM-associated TB and the emergence of multi-drug resistant tuberculosis (MDR-TB). 5 This article was published in the following Dove Press journal: Therapeutics and Clinical Risk Management Although TB was once effectively controlled, the incidence in many countries rebounded in the 1980s and it has again become a major disease threatening public health. In addition to cases with typical symptoms, the number of nontypical TB cases is increasing significantly, and these are often associated with a chronic dry cough (pulmonary tuberculosis [PTB] ) and chronic hoarseness (laryngeal TB). 6 Patients with nontypical TB symptoms often consult with otolaryngologists; therefore, doctors from all departments should be well aware of all possible symptoms of TB and should know that patients with DM are at a high risk of TB 7 and that TB can increase the occurrence and development of DM. 8 More attention is being paid to the coexistence of these two diseases by investigators, public health organizations, governments, and policy makers.