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Clinical management of concurrent diabetes and tuberculosis and the implications for patient services

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dc.contributor.author Riza, Anca Lelia
dc.contributor.author Pearson, Fiona
dc.contributor.author Ugarte Gil, Cesar Augusto
dc.contributor.author Alisjahbana, Bachti
dc.contributor.author van de Vijver, Steven
dc.contributor.author Panduru, Nicolae M.
dc.contributor.author Hill, Philip C.
dc.contributor.author Ruslami, Rovina
dc.contributor.author Moore, David Alexander James
dc.contributor.author Aarnoutse, Rob
dc.contributor.author Critchley, Julia A.
dc.contributor.author van Crevel, Reinout
dc.date.accessioned 2022-01-04T20:31:44Z
dc.date.available 2022-01-04T20:31:44Z
dc.date.issued 2014
dc.identifier.uri https://hdl.handle.net/20.500.12866/10588
dc.description.abstract Diabetes triples the risk for active tuberculosis, thus the increasing burden of type 2 diabetes will help to sustain the present tuberculosis epidemic. Recommendations have been made for bidirectional screening, but evidence is scarce about the performance of specific tuberculosis tests in individuals with diabetes, specific diabetes tests in patients with tuberculosis, and screening and preventive therapy for latent tuberculosis infections in individuals with diabetes. Clinical management of patients with both diseases can be difficult. Tuberculosis patients with diabetes have a lower concentration of tuberculosis drugs and a higher risk of drug toxicity than tuberculosis patients without diabetes. Good glycaemic control, which reduces long-term diabetes complications and could also improve tuberculosis treatment outcomes, is hampered by chronic inflammation, drug-drug interactions, suboptimum adherence to drug treatments, and other factors. Besides drug treatments for tuberculosis and diabetes, other interventions, such as education, intensive monitoring, and lifestyle interventions, might be needed, especially for patients with newly diagnosed diabetes or those who need insulin. From a health systems point of view, delivery of optimum care and integration of services for tuberculosis and diabetes is a huge challenge in many countries. Experience from the combined tuberculosis and HIV/AIDS epidemic could serve as an example, but more studies are needed that include economic assessments of recommended screening and systems to manage concurrent tuberculosis and diabetes. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Lancet. Diabetes and Endocrinology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Blood Glucose en_US
dc.subject Drug Interactions en_US
dc.subject Global Health en_US
dc.subject Immunocompromised Host en_US
dc.subject Prognosis en_US
dc.subject AIDS-Related Opportunistic Infections en_US
dc.subject Antitubercular Agents en_US
dc.subject Chemoprevention en_US
dc.subject Diabetes Mellitus en_US
dc.subject HIV Infections en_US
dc.subject HIV-1/isolation & purification en_US
dc.subject Tuberculosis en_US
dc.title Clinical management of concurrent diabetes and tuberculosis and the implications for patient services en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/S2213-8587(14)70110-X
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.relation.issn 2213-8595


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