Pulmonary tuberculosis in diabetes: Exploring the intersection and impact on mental health

Abstract

There is a bidirectional association between type II diabetes mellitus (T2DM) and pulmonary tuberculosis (PTB), with each enhancing the risk of the other, thus increasing the burden of both drug-sensitive and drug-resistant forms of the disease. This dual burden also has a detrimental impact on patient's mental health. Although several recommendations have been made for bidirectional screening of diabetes and tuberculosis, implementation remains poor, resulting in increased morbidity and mortality among patients with this comorbidity. Mental health is often neglected, as clinical outcomes receive disproportionate focus, with limited attention to patients’ social and psychological well-being. According to the World Health Organization, health is defined as a state of physical, mental, and social well-being, and not merely the absence of disease or infirmity. The aim of this mini-review is to highlight the intersection of PTB and T2DM, specifically discussing the mental health outcomes of the co-burden.

Keywords: Mycobacterium tuberculosis; Multi-drug resistance; Diabetes; Depression; Quality of life

Core Tip: Pulmonary tuberculosis (PTB) and Diabetes Mellitus type 2 (T2DM) both significantly increase the risk of mental health disorders, particularly depression and anxiety. Mental health issues in PTB patients are often underdiagnosed and undertreated, which can negatively affect treatment outcomes. Early screening and integrated care for mental health within co-morbid PTB and T2DM treatment programs are crucial for patient recovery. Stigma, social isolation, and financial burdens contribute to the psychological distress experienced by PTB patients with T2DM. Multidisciplinary approaches involving mental health professionals are essential for the holistic management of PTB.