World Diabetes Day: Putting a spotlight on the dual burden of diabetes and TB
14 November 2020, Geneva | Tuberculosis (TB) remains the world’s top infectious killer claiming 1.4 million lives in 2019. As we mark World Diabetes Day on 14th November, we need to underscore the role of diabetes as a key driver for TB and a risk factor for poor tuberculosis treatment outcomes in people with diabetes. Diabetes is also associated with a two-fold risk of death during TB treatment and a four-fold risk of TB relapse after treatment completion. Diabetes is associated with a 2-3 times increased risk of TB, including drug resistant TB. Evidence suggests that the risk of TB increases with poorly managed diabetes. Diabetes was the cause of TB in an estimated 350,000 people in 2019 – many of which could have been prevented had diabetes been prevented or well managed. Diabetes and TB place a heavy dual burden on those ill with both diseases.
More than 420 million people are living with diabetes, and it is
unfortunately on the rise in countries with a high burden of TB
and where the basic technology for diagnosing and treating
diabetes is often lacking in primary care and the public sector.
The negative impact of COVID-19 on access to early diagnosis and
management of diabetes is likely to further fuel the
tuberculosis and diabetes epidemics.
“Disruption of treatment and delays in follow-up
experienced during the COVID-19 pandemic will likely increase
the number of people who are susceptible to a recurring or new
episode of TB. This is one of the reasons why WHO is announcing
the
WHO Global Diabetes Compact, a comprehensive and inclusive approach to support countries
in implementing effective programmes for the prevention and
management of diabetes” said Dr Bente Mikkelsen, Director
NCDs at WHO.
This all strengthens the case for expanding access to
integrated, bidirectional screening and co-management of TB and
diabetes. It also calls for increased investment in the
prevention, diagnosis and treatment of diabetes as critical
interventions for ending TB. In 2018, at the respective UN
High-Level Meetings on TB and non-communicable diseases (NCDs),
Member States committed to strengthening integrated care for TB
and NCDs such as diabetes. However, implementation in high TB
burden countries is still limited.
“Diabetes is an increasingly important determinant of TB,
and the main driver of TB epidemics in several countries in
Latin America. Prevention and effective management of diabetes
are essential to reducing the risk of TB. As we work to assure
Universal Health Coverage in the context of the COVID-19
pandemic, now is the time to work together to build synergies
and strengthen the primary health care platform for the future.
Now is the time to consider common strategies to address
COVID-19, diabetes and TB, and expand access to prevention,
diagnosis and comanagement, as well as strengthen infection
control measures,” said Dr Tereza Kasaeva, Director of
WHO’s Global TB Programme. “And now is the time to
work with stakeholders across sectors and funding agencies to
push forward the common agenda and to ensure
accountability”.
Source:
WHO
