Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

India’s diabetes epidemic is making its widespread TB problem worse


From UPSC perspective, the following things are important :

Prelims level: DM and Tb related facts

Mains level: The dual burden of India, TB and Diabetes, Interconnection, challenges and treatment measures


What is the news?

  • India has long grappled with two major epidemics: type 2 diabetes (diabetes mellitus, DM) and tuberculosis (TB). With a staggering 74.2 million people living with diabetes and 2.6 million new TB cases each year, it is crucial to understand the deep interconnection between these diseases.

Central Idea

  • The diabetes mellitus (DM) and tuberculosis (TB) are closely interconnected in India, with DM increasing the risk and severity of TB, and TB co-infection worsening diabetes outcomes. Among people with TB, the prevalence of DM was found to be 25.3% while 24.5% were pre-diabetic. Which highlights the need for urgent action to address this dual burden and improve care coordination for individuals affected by both diseases.

What is type 2 diabetes?

  • Type 2 diabetes, also known as diabetes mellitus (DM), is a chronic metabolic disorder characterized by high blood sugar levels.
  • It is the most common form of diabetes and typically develops over time, often in adulthood.
  • In type 2 diabetes, the body either becomes resistant to the effects of insulin (a hormone that helps regulate blood sugar levels) or does not produce enough insulin to maintain normal glucose levels.

What is tuberculosis (TB)?

  • TB is an infectious disease caused by the bacterium Mycobacterium tuberculosis.
  • It primarily affects the lungs but can also affect other parts of the body, such as the kidneys, spine, and brain.
  • TB is transmitted through the air when an infected individual coughs, sneezes, or speaks, releasing tiny droplets containing the bacteria. When inhaled by others, these droplets can lead to infection


The interconnection and Impact of DM on TB

  • Increased Risk of TB: People with DM have a higher risk of developing TB compared to those without DM. DM weakens the immune system and impairs the body’s ability to fight off infections, including TB.
  • Increased TB Severity: When individuals with DM acquire TB infection, they tend to have a higher bacterial load, which means there are more TB bacteria in their bodies. This can result in more severe symptoms and complications associated with TB.
  • Delayed Sputum Conversion:
  • Sputum conversion refers to the transition from having TB bacteria detectable in the sputum (positive) to no longer having detectable bacteria (negative) after initiating treatment.
  • Individuals with both TB and DM often experience delayed sputum conversion compared to those with TB alone.
  • It means that it takes longer for the TB bacteria to be eliminated from their bodies, prolonging the infectious period and potentially increasing the risk of transmitting the disease to others.
  • Altered Treatment Outcomes:
  • TB treatment outcomes can be affected by the presence of DM. Individuals with both TB and DM may experience modified TB symptoms, radiological findings, and lung functioning compared to those with TB alone.
  • Studies have shown that individuals with TB and DM have reduced lung functioning even after completing TB treatment.
  • Respiratory Complications: Individuals with both TB and DM are more prone to experiencing respiratory complications related to TB. Respiratory complications can be a common cause of death in this population, highlighting the increased severity of TB when DM is present.

What measures India must take to combat the dual burden of DM and TB

  • Integrated Care: Implement patient-centered care approaches that address the unique needs of individuals with both TB and DM, along with other comorbidities. This includes coordinated diagnosis and treatment, bidirectional screening, patient education, and support.
  • Holistic Treatment Plans: Strengthen high-quality care for TB, DM, and associated comorbidities by developing holistic treatment plans. Prioritize individual programs for TB and DM and ensure their integration into healthcare services.
  • Resilient Health Systems: Build and scale up resilient and integrated health systems by garnering increased commitment from stakeholders, formulating robust policy guidance, and mobilizing additional resources. These efforts will support the development of effective strategies to combat both diseases.
  • Data-Driven Decision Making: Enhance the research literature on TB and DM interactions to enable better decision-making. Access to comprehensive data and ongoing studies will provide critical insights for improving patient care and raising awareness of the impact of these interconnected diseases


  • The coexistence of diabetes mellitus and tuberculosis in India demands immediate attention. By adopting integrated care models, improving treatment outcomes, and strengthening health systems, we can effectively address the dual burden of DM and TB. It is essential for health professionals, policymakers, and communities to prioritize research, enhance collaboration, and work together to improve the lives of those affected by these intertwined epidemics.

Also read for more details:

Is India a Diabetes capital of the world?

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