Diabetic patients face triple risk of contracting TB

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MEXICO – Diabetes killed almost 100 000 people in Mexico last year alone, according to Dr Jesus Felipe Gonzalez, a director general at the country’s Health Ministry. And although not widely-known, tuberculosis (TB) adds to that burden. Research has shown diabetic patients are up to three times more at risk of developing TB than non-diabetics.

But Gonzalez said that Mexico has taken significant steps to tackle this “urgent problem”: steps that countries like South Africa, suffering from heavy TB and diabetes rates, might learn from.

“We were one of the first countries to introduce a tax on sugary beverages,” he told Health-e News, referring to the tax on sweetened drinks the country’s Congress introduced in 2013.

Earlier this year research conducted by the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health and the Mexican Instituto Nacional de Salud Pública found that the 10 percent tax resulted in an over seven percent decline in the consumption of these products over a two-year period.

Excess sugar, especially in liquid form, has been found to be dangerous to one’s health, aiding rates of obesity and diabetes in particular, which is why South Africa has proposed a similar tax which is likely to be passed in April 2018.

Gonzalez said one the obstacles has been that diabetic patients who also have TB had historically low treatment compliance rates: meaning they struggled to take their medication as prescribed.

This can have sometimes fatal consequences. Uncontrolled diabetes can lead to severe consequences like amputations and blindness, while skipping TB pills is very dangerous and can lead to the development of drug-resistant TB and much lower chances of survival.

But since the country introduced a routine four-in-one pill for TB treatment – similar to the fixed-dose-combination HIV pill – TB cases have dropped and patients are finding it easier to take their medication as they should.

“We have the highest treatment compliance [90 percent] rate in Latin America,” said Gonzalez.

South Africa has not introduced this combination pill despite the fact that diabetes is the leading killer of women with TB coming in second, according to Statistics South Africa.

Ahead of the Union World Conference on Lung Health taking place in Mexico this week chief executive officer of the Noncommunicable Diseases Alliance (NCDA), Katie Dain warned against public health actors working in “silos”.

She said funding was also a critical issue for noncommunicable diseases (NCDs) – which include conditions like diabetes to mental health and cancers.  She said that less than three percent of global donor funding is spent on NCDs which is “woefully inadequate”.

NDCA president Jose-Luis Castro said that unlike contagious diseases like HIV which pose immediate public health threats, NCDs are slower to show their disastrous impact on nations’ health.

Combining approaches to treating both infectious diseases and NCDs is one way of tackling the problem.

Gonzalez said although the sugar tax has shown benefits it is only one strategy in the government’s plan to combat diabetes as well as TB. Others include making cities more accessible to pedestrians and cyclists, public awareness campaigns, better access to diagnosis and treatment and stricter regulations on tobacco.

According to Castro the link between TB and diabetes is not a well-known fact despite its implications.

He said that policy-makers and the public need to know that NCDs and TB will spread like “wildfire” unless evidence-based action is taken.

“There isn’t the fear, the urgency needed – we need to create that.” he said. – Health-e News.

Amy Green is a Health reporter at Health-e News Service