Clinical challenges in the co-management of diabetes mellitus and tuberculosis in Southern Africa
JEMDSA (Online)
; 18(3): 135-140, 2014.
Article
in English
| AIM
| ID: biblio-1263746
Responsible library:
CG1.1
ABSTRACT
Over the past 20 years; tuberculosis incidence in southern Africa has increased at an alarming rate; fuelled primarily by the human immunodeficiency virus epidemic. The emerging prevalence of diabetes mellitus in the region represents a new threat to tuberculosis control. The intersecting double burden is a cause for concern since diabetes mellitus increases the risk of tuberculosis and results in poor treatment outcomes. This review article discusses the evidence of a causal association between these two conditions; and examines the numerous clinical challenges that relate to tuberculosis and diabetes mellitus co-management. Diabetes is associated with a more advanced age and body weight in patients with tuberculosis; although not with a specific clinical presentation of tuberculosis. Rifampicin adversely alters glycaemic control by lowering the concentrations of most oral antidiabetic drugs. Poor glycaemic control; possibly exacerbated by tuberculosis and anti-tuberculous therapy; is an important contributing factor to tuberculosis case fatality and relapse. Clinicians need to be aware of these clinical and pharmacological challenges when co-managing these complex diseases
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Index:
AIM (Africa)
Main subject:
South Africa
/
Tuberculosis
/
Causality
/
Disease Management
/
Diabetes Mellitus
Type of study:
Risk factors
Country/Region as subject:
Africa
Language:
English
Journal:
JEMDSA (Online)
Year:
2014
Type:
Article
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