Collaborative framework for care and control of tuberculosis and diabetes
Overview
Diabetes triples the risk of developing tuberculosis (TB). Consequently, rates of TB are higher in people with diabetes than in the general population, and diabetes is a common comorbidity in people with TB. Diabetes can worsen the clinical course of TB, and TB can worsen glycaemic control in people with diabetes. Individuals with both conditions thus require careful clinical management. Strategies are needed to ensure that optimal care is provided to patients with both diseases: TB must be diagnosed early in people with diabetes, and diabetes must be diagnosed early in people with TB.
Given the absence of international guidelines on the joint management and control of TB and diabetes, the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (the Union) identified key questions to be answered and commissioned systematic reviews of studies addressing those questions. A series of expert consultations were organized to assess the findings of the systematic reviews and a guideline group was established to develop this provisional collaborative framework.
The framework aims to guide national programmes, clinicians and others engaged in care of patients and prevention and control of diabetes and TB on how to establish a coordinated response to both diseases, at organizational and clinical levels.