Several studies show that people with diabetes have an increased risk of tuberculosis (TB), including three conducted at the University of Texas School of Public Health Brownsville Regional Campus (UTSPH). According to the researchers, patients with tuberculosis who identified themselves as being diabetic tended to have a more severe form of tuberculosis. They were more likely to cough up blood, have cavities in the lung tissue, poorer response to drug treatment and a higher rate of the illness compared to those without diabetes.

"There is some direct evidence that diabetes lowers the immune system, making diabetics more prone to infection and slower to heal," said Dr. Joseph B. McCormick, senior author of an article about the study and James Steele Professor in the Center for Infectious Diseases at the UTSPH. "Our hypothesis is that diabetic people harboring the tuberculosis bacteria in their lungs are no longer able to keep it at bay and it goes from latent to active."

The American Diabetes Association (ADA) agrees that people with diabetes are more at risk for certain types of infections and illnesses because of prolonged high blood glucose. "Some older studies using petri dishes indicate that high blood glucose will impair white blood cells that fight bacterial infections," explains M. Sue Kirkman, the association's vice president of clinical affairs.

For health experts, the diabetes and tuberculosis link is particularly troubling considering the explosion of diabetes rates globally. Low- to middle-income countries are especially at risk with their accelerated rise of diabetes cases and high rates of tuberculosis. In the U.S. tuberculosis rates stabilized in 2006, however they continue to be a major concern in minority and immigrant populations throughout the country.

"Blacks and Hispanics have tuberculosis rates that are about eight times higher than that of whites, and the rate for Asians is more than 21 times that of whites. Foreign-born individuals living in the United States have nearly 10 times the rate of TB as those born in the United States," said Dr. Kevin Fenton, director of the Centers for Disease Control National Center for HIV, STD and TB Prevention in Morbidity and Mortality Weekly Report.

Diabetes and Tuberculosis: Breaking the Connection
Both diabetes and tuberculosis are chronic illnesses, requiring close management and specialized care. If you have diabetes it's essential that you boost your immune system to avoid getting tuberculosis and other illnesses. The ADA recommends the following strategies:

It's critical to lower high blood glucose levels as they harm white blood cells - the frontline soldiers in the battle against disease and illness. Monitor your blood glucose levels daily and take your insulin injections or other diabetes medication as prescribed. Also, try to eat a healthy diet rich in low-glycemic foods, such as vegetables, whole grains and fish.

According to the ADA, people who exercise regularly get about half as many respiratory infections as sedentary people. It gives your immune system a healthy workout, and it also releases stress and tension that undermine your immune system. It also helps to control your blood glucose levels to further reduce your diabetes and tuberculosis risk. Try to get at least 30 minutes of exercise five days a week or more.

Long-term or chronic stress suppresses your immune system's ability to suss out invaders and weakens the attack it can mount against them, states the ADA. Eventually it wears down and damages your immune system's ability to turn itself on and off at appropriate times, increasing your odds of suffering from both diabetes and tuberculosis.

Those 40 winks and afternoon naps help to maintain a balance of immune cells called monocytes, which strengthens your immunity against foreign invaders, states the ADA. When your body doesn't get enough rest the number and efficiency of immune cells decreases.

Diabetes can increase sleeplessness, but exercise helps to improve your sleep. Here are a few other tips for a better night's sleep:
- Try to go to bed at the same time every night.
- Make your bedroom conducive to sleeping - use dark curtains and white noise, and have a comfortable mattress and pillows.
- Drink milk or have a warm (not hot) bath about one hour before bedtime.

Study Reference
University of Texas Health Science Center at Houston press release.