Persons with Type 2 Diabetes and Co-morbid Active Tuberculosis Should Be Treated with Insulin

Tuberculosis remains a significant cause of morbidity and mortality in diabetes in developing countries. The magnitude of the problem should be considered with serious concern as overwhelmingly larger number of people in our country have type 2 diabetes and they are more likely to suffer from reactivation of old foci and contracting fresh infection. Tuberculosis is a chronic and serious infection which also affects endocrine function of pancreas, adrenal, thyroid and pituitary, warranting exogenous insulin and other hormone replacements. Oral antidiabetic therapy is definitely contraindicated in tuberculosis, as marked weight loss, adversity of aging, longer duration of diabetes, higher insulin and calorie needs, and likely hepatotoxicity of ATT are the hallmarks of tuberculosis infection. Better glycemic control can only be achieved with intensive insulin treatment regimens.