Background and aims: Diabetes mellitus (DM) is a risk factor for pulmonary tuberculosis (TB), increasing the risk of progression of latent tuberculosis infection (LTBI) to active TB threefold, threatening the TB control, especially in developing countries. The aim of this study was to assess active and latent TB infection frequency in patients with DM.
Material and methods: There were enrolled in this study 503 adult DM patients. Active TB screening was performed through anamnestic data, clinical examination and chest X-ray and latent TB infection screening was evaluated using the tuberculin skin tests (TST).
Results: A number of 63 (12.5%) patients had type 1 DM and 440 (87.5%) had type 2 DM. Personal history of TB was present in 21 (4.2%) subjects, 5 (8.1%) with type 1 DM and 16 (3.6%) with type 2 DM. The TST was positive in 258 (51.5%) patients and 54 (10.7%) presented cough for more than two weeks at the time of examination. The chest X-ray revealed suggestive lesions for active TB in 4 (1%) subjects and lesions of inactive TB in 90 (22.4%) subjects.
Conclusions: TB screening must receive proper attention in patients with DM, being essential for diagnosis in those with nonspecific symptoms.
Tuberculosis (TB) and diabetes mellitus (DM) are two chronic diseases with major impact on worldwide morbidity and mortality. DM significantly increases the risk of death, therapeutic failure and relapse of TB, requiring a much more careful monitoring of these patients. In this article we present the case of a patient with type 2 DM in the stage of major chronic complications, with numerous risk factors for TB and atypical symptomatology, pulmonary X-ray showing active TB lesions. The patient did not follow the diabetologist's recommendations, discontinuing the antidiabetic treatment on his own initiative. The glycemic imbalance and chronic alcoholism caused the failure of the anti TB therapy.
Adela-Gabriela Firănescu, Adina Popa, Maria-Magdalena Sandu, Diana Cristina Protasiewicz, Simona Georgiana Popa and Maria Moţa
Diabetes Mellitus (DM) and Tuberculosis (TB) are two chronic diseases which have a major impact on the population health in developing countries. DM is a chronic, noncommunicable disease, characterized by hyperglycemia, caused by insulin-resistance, inadequate insulin secretion or both. TB is a disease caused by Mycobacterium tuberculosis, an airborne bacteria. DM implies a three times greater risk of developing TB and their association can be considered one of the most important challenges regarding TB control. TB can cause a temporary impaired glucose tolerance, which is a risk factor for DM development. The possibility of relapse or death of a patient with TB is significantly higher when the patient also has DM. The DM-TB association represents an important threat to the population health and requires the implementation of adequate programs in order to reduce the prevalence and incidence of the two diseases.
Adela-Gabriela Firănescu, Adina Popa, Maria-Magdalena Roşu, Diana Cristina Protasiewicz, Simona Georgiana Popa, Mihai Ioana and Maria Moța
Worldwide, tuberculosis (TB) is a major cause of morbi-mortality, about 30% of the population having a Mycobacterium tuberculosis infection. Patients with diabetes mellitus (DM) have a threefold increased risk of developing the disease. The prevalence of DM is rapidly increasing, especially in countries with low and middle income, where TB incidence is also increased, thus baffling the efforts for TB control. The DM-TB co-epidemic is more frequent in married, older men, with reduced level of education, low income, without a steady job, with lifestyle habits such as alcohol consumption, smoking, sedentarism, living in an urban environment, in crowded areas, in insanitary conditions. These patients have a higher body mass index (BMI) compared with those without DM and frequently present family history of TB, family history of DM, longer duration of DM and reduced glycemic control. TB associated with DM is usually asymptomatic, more contagious, multidrug resistant and is significantly associated with an increased risk of therapy failure, relapse and even death. Thus, the DM-TB comorbidity represents a threat to public health and requires the implementation of urgent measures in order to both prevent and manage the two diseases.
Diana Cristina Protasiewicz, Adina Popa, Maria-Magdalena Roşu, Adela-Gabriela Firănescu, Simona Georgiana Popa and Maria Moța
Humans spend almost one third of their life sleeping, thus sleep deprivation or poor sleep quality will have consequences upon the quality of life. Obstructive sleep apnea (OSA) is the most common sleep disorder that represents a respiratory cessation for at least ten seconds, which appears repeatable during sleep and it is accompanied by decreased oxygen saturation. The diagnosis of OSA is possible by filling in the STOP, STOP BANG, BERLIN questionnaires and performing the polysomnography, an accessible and more accurate method but yet very expensive. The prevalence of OSA is continuously increasing, but because of the nonspecific symptoms, the percentage of un-diagnosed cases is further increased. Data from 11 epidemiological studies published between 1993 and 2014 indicated an OSA prevalence of 22% in men and 17% in women. It has been suggested that there is a bidirectional causal relationship between OSA and obesity, and numerous studies have shown association of OSA with insulin resistance, diabetes mellitus, diabetic micro- and macrovascular complications and atrial fibrillation.
Maria-Magdalena Sandu, Diana Cristina Protasiewicz, Adela Gabriela Firănescu, Elena Cristina Lăcătuşu, Mihaela Larisa Bîcu and Maria Moţa
Diabetes Mellitus (DM) represents one of the highest challenges in our century, due to the fact that in the last 20 years the number of patients with DM has doubled, at present affecting hundreds of millions of people worldwide, both in developed countries and in developing ones, as well. One of the most serious consequences of this increase is the onset of type 2 DM in children, adolescents and young people, the main causes being an unhealthy lifestyle: unhealthy food, lack of physical exercise, which, most of the times, lead to obesity. Also, DM is often associated to micro and macrovascular complications, thus determining disabilities and high costs in the healthcare systems, respectively. DM is one of the main causes of death all over the world, a reason for which there are required prevention programs worldwide.