A COMPREHENSIVE REVIEW ON IMPACT OF DIABETES MELLITUS ON TUBERCULOSIS TREATMENT OUTCOMES

Shaik Faziha*, T. Tulasi, Dr. E. Sunil Kumar

ABSTRACT

Tuberculosis (TB) and diabetes mellitus (DM) are two of the most serious global health threats, and their co-occurrence has made the management of these diseases even more challenging. The growing burden of diabetes, especially in countries with high TB prevalence, has contributed to the rising incidence of TB-DM co-infection. Diabetes mellitus affects the innate and adaptive immune systems, making patients more vulnerable to Mycobacterium tuberculosis infection, resulting in delayed sputum conversion, increased bacterial load, treatment failure, relapse, and mortality. This review critically evaluates the effects of diabetes mellitus on the treatment outcomes of tuberculosis, the pathophysiologic mechanisms, pharmacokinetic interactions, and clinical management issues. Findings from the existing literature, including epidemiological, clinical, and pharmacological studies, suggest that hyperglycemia is a major factor that reduces the effectiveness of anti-TB medications and the host's immune system. Moreover, diabetes mellitus is also linked to multidrug-resistant TB and poor treatment outcomes. Comprehensive screening, glycemic control, personalized treatment plans, and two-way approaches for TB-DM management are required to improve treatment outcomes. To lessen this double burden, cooperative partnerships between national programs for non-communicable diseases and tuberculosis are essential. Future research should focus on identifying effective treatment regimens and host-directed therapies for TB patients with diabetes.

Keywords: Tuberculosis; Diabetes Mellitus; Treatment Outcomes; Hyperglycemia; Multidrug-Resistant Tuberculosis; Glycemic Control; Sputum Conversion; Pharmacokinetics; Immune Dysfunction; TB–DM Comorbidity.