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Tuberculous hyperglycaemia: a clinical, epidemiological and public health perspective
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Tuberculous hyperglycaemia: a clinical, epidemiological and public health perspective
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Journal Article
Tuberculous hyperglycaemia: a clinical, epidemiological and public health perspective
2025
Overview
DM is a well-established risk factor for TB, increasing susceptibility to the disease and worsening treatment outcomes.1–3 Compounding this, TB patients with uncontrolled hyperglycaemia—whether due to pre-existing DM or TB-induced stress hyperglycaemia—face a higher risk of poor TB outcomes.4–6 In response, the WHO has recommended diabetes screening for TB patients since 2011.7 A critical challenge in diagnosing diabetes among TB patients Since this recommendation, numerous studies have reported that many new DM diagnoses occur during diabetes screening for patients newly diagnosed with TB.8–10 A systematic review found that an average of 22% (range: 8%–87%) of TB patients with diabetes were newly diagnosed with DM at the time of their TB diagnosis.10 These findings suggest that DM screening in TB patients is feasible and effective for identifying previously undiagnosed diabetes. Studies indicate that individuals newly diagnosed with diabetes are at heightened risk for depression, anxiety and distress, which can negatively impact treatment adherence and quality of life.13 TB itself imposes substantial psychological strain due to stigma, social isolation and financial hardship.14 A concurrent DM diagnosis can exacerbate these challenges, negatively affecting mental health, treatment adherence and overall well-being. Health providers play a key role in reassuring patients about the nature of tuberculous hyperglycaemia while ensuring appropriate long-term diabetes management when necessary. Mental Health Status and Its Impact on TB Treatment and Its Outcomes: A Scoping Literature Review.
