Diabetes mellitus and tuberculosis: programmatic management issues

This article identifies some of the major programmatic management challenges


In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases. Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation.

Key programmatic challenges include the following:

  • whether screening should be directed at all patients or targeted at those with high-risk characteristics;

  • the most suitable technologies for diagnosing TB and diabetes in routine settings;

  • the best time to screen TB patients for DM;

  • how to provide an integrated, coordinated approach to case management;

  • how to persuade non-communicable disease programmes to adopt a cohort analysis approach, preferably using electronic medical records, for monitoring and evaluation.

The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB.

This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)


A. D. Harries, A. M. V. Kumar, S. Satyanarayana, Y. Lin, R. Zachariah, K. Lonnroth, A. Kapur (2015) Diabetes mellitus and tuberculosis: programmatic management issues International Journal of Tubercelosis and Lung Disease Volume 19, Number 8, 1 August 2015, pp. 879-886(8)http://dx.doi.org/10.5588/ijtld.15.0069

Diabetes mellitus and tuberculosis: programmatic management issues

Published 1 August 2015