The cause-effect relation of tuberculosis on incidence of diabetes mellitus

Front Cell Infect Microbiol. 2023 Jun 26:13:1134036. doi: 10.3389/fcimb.2023.1134036. eCollection 2023.

Abstract

Tuberculosis (TB) is one of the oldest human diseases and is one of the major causes of mortality and morbidity across the Globe. Mycobacterium tuberculosis (Mtb), the causal agent of TB is one of the most successful pathogens known to mankind. Malnutrition, smoking, co-infection with other pathogens like human immunodeficiency virus (HIV), or conditions like diabetes further aggravate the tuberculosis pathogenesis. The association between type 2 diabetes mellitus (DM) and tuberculosis is well known and the immune-metabolic changes during diabetes are known to cause increased susceptibility to tuberculosis. Many epidemiological studies suggest the occurrence of hyperglycemia during active TB leading to impaired glucose tolerance and insulin resistance. However, the mechanisms underlying these effects is not well understood. In this review, we have described possible causal factors like inflammation, host metabolic changes triggered by tuberculosis that could contribute to the development of insulin resistance and type 2 diabetes. We have also discussed therapeutic management of type 2 diabetes during TB, which may help in designing future strategies to cope with TB-DM cases.

Keywords: Mycobacterium tuberculosis; diabetes; inflammation; insulin resistance; therapeutic strategies.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Humans
  • Hyperglycemia*
  • Incidence
  • Insulin Resistance*
  • Tuberculosis* / complications
  • Tuberculosis* / epidemiology

Grants and funding

The laboratory of SM is supported by the grant from the Department of Biotechnology (DBT), Govt. of India (BT/PR35722/BRB/10/1837/2019), Department of Science and Technology-Science and Engineering Research Board (DSTSERB), Govt. of India (JCB/2021/000035, CRG/2019/000239), Council of Scientific and Industrial Research (CSIR), Govt. of India (27(0364)/20/EMRII), Indian Council of Medical Research (ICMR), Govt of India (2021-10087/GTGE/ADHOC-BMS) and a core grant from CDFD by DBT. MKB and PD are supported by the fellowships from Council of Scientific and Industrial Research (CSIR), Govt. of India and DBT respectively.