If you’ve been paying attention to the global health scene, you know that tuberculosis (TB) is a massive problem. It’s the second-deadliest infectious disease, only recently getting knocked out of the top spot by—you guessed it—COVID-19. But there’s another player in the health world that’s making TB even more of a beast: diabetes.

Here’s the kicker: while we usually think of diabetes as a sugar problem and TB as a lung issue, when these two team up, they wreak havoc on a level that’s way more than the sum of their parts. Let’s break it down.

TB: The Comeback Kid Nobody Wanted

TB isn’t new—it’s been around for centuries, and it’s still a major killer, especially in parts of Asia and Africa. The numbers are staggering: about 10.6 million people got TB in 2022, and 1.3 million didn’t survive it. That’s not just sad; it’s a major blow to global health efforts to end TB as a public health nightmare by 2035.

And just when we thought we had TB on the ropes, COVID-19 swooped in and stole the spotlight. With healthcare systems focusing on the pandemic, TB cases surged again, setting back years of progress. It’s like dealing with a fire in your backyard, only to have a tornado hit right afterward.

Enter Diabetes: The Sneaky Partner-in-Crime

Now, let’s talk about diabetes—a condition that affects over 537 million people globally. It’s not just about managing blood sugar; diabetes messes with your immune system, making it harder for your body to fight off infections. This is where TB finds an opportunity.

When you have diabetes, your body’s defenses are down, and TB bacteria, always lurking in the background, can strike more easily. Studies show that people with diabetes are up to three times more likely to develop TB than those without it. If you’re unlucky enough to have both, your risk of dying from TB skyrockets.

A Global Tug-of-War

The overlap between TB and diabetes is particularly gnarly in regions already struggling with poverty and weak healthcare systems. Imagine trying to treat TB in a place where diabetes care is hit or miss. It’s like trying to put out a fire while someone’s cutting off your water supply.

The WHO’s got its hands full trying to tackle this double whammy. They’re focusing on better TB detection, early treatment, and preventive measures like the BCG vaccine. But they’re also trying to tackle the root causes—things like poverty, malnutrition, and yes, the rise of diabetes, particularly in low- and middle-income countries.

Why It Matters to You

So, why should you care? Because this isn’t just a “their problem” issue. With global travel and interconnected economies, what happens in one part of the world can quickly become a global issue. Plus, controlling TB and diabetes at the global level means fewer health threats and lower healthcare costs for everyone.

The Bottom Line

Diabetes and TB are a deadly duo, particularly in vulnerable populations. As the number of people with diabetes continues to climb, especially in regions already hit hard by TB, this problem isn’t going away. The world needs to step up its game—by investing in better healthcare systems, ensuring access to essential medications, and tackling the root causes of both diseases.

In the meantime, stay healthy, keep your blood sugar in check, and remember: the fight against TB and diabetes is far from over, and we all have a role to play.

Franco JV, Bongaerts B, Metzendorf MI, Risso A, Guo Y, Peña Silva L, Boeckmann M, Schlesinger S, Damen JA, Richter B, Baddeley A, Bastard M, Carlqvist A, Garcia-Casal MN, Hemmingsen B, Mavhunga F, Manne-Goehler J, Viney K. Diabetes as a risk factor for tuberculosis disease. Cochrane Database Syst Rev. 2024 Aug 23;8(8):CD016013. doi: 10.1002/14651858.CD016013.pub2. PMID: 39177079; PMCID: PMC11342417.