November 14 is World Diabetes Day. This is a day that serves as a reminder to all progressive humanity that the prevalence of the disease is constantly increasing. For the first time, World Diabetes Day was held by the IDF (International Diabetes Federation) and the World Health Organization on November 14, 1991 to coordinate the fight against diabetes worldwide. Thanks to the activities of the IDF, World Diabetes Day reaches millions of people around the world and unites diabetic communities in 145 countries with the noble goal of raising awareness about diabetes and its complications.
This problem has a centuries-old history and its roots go back to the time of Avicenna (980 – 1037). In the pre-insulin era, tuberculosis contributed to diabetes mellitus (hereinafter referred to as DM) in 40-50% cases and patients died after 1-2 years. After the introduction of insulin (1922), and then anti-tuberculosis drugs (1944-1945), the combination of these diseases decreased and the life expectancy of patients increased. At the same time, the development of pulmonary tuberculosis against the background of DM is observed 4-9 times more often than in the rest of the population.
The urgency of the problem is due to the fact that the incidence of diabetes mellitus is increasing. It has been established that the number of patients with diabetes mellitus doubles every 15 years. Mass screening examinations have shown that in developed countries, from 2 to 41% of the population suffers from severe forms of diabetes mellitus. In addition, latent or borderline forms of diabetes, designated as «impaired glucose tolerance», are detected in 4-61% of the population.
Over the past ten years, the prevalence of diabetes in Ukraine has increased by one and a half times, and as of January 1, 2015, 1,198,047 patients were registered in the country, which is about 2.91% of the total population (data provided without taking into account the territories temporarily not under the control of the Government of Ukraine - the Autonomous Republic of Crimea, Donetsk and Luhansk regions). If we take into account that for every registered case there are two to three cases of undiagnosed disease, this figure will be more than 2-2.5 million patients.
Among the indicated number of patients with type 1 diabetes in Ukraine, about 85 thousand people are sick, and the rest (90%) are diagnosed with type 2 diabetes. The difference is that in type 1 diabetes, the cells of the pancreas produce insufficient or no insulin at all. Such patients are treated from the very beginning with insulin, which replaces their own. The incidence of type 1 diabetes should not increase sharply, since in most cases the problem is hereditary. The cause may also be autoimmune diseases. Usually, patients are diagnosed in childhood or at a fairly young age.
In Ukraine, diabetes ranks 3rd in prevalence after CVD and oncology. Being aware of the risks, signs, and preventive measures; regularly checking blood glucose levels (normal 3.89-5.83) is the minimum we should do.
Tuberculosis is not inferior in its positions. In 2015, according to the Center for Medical Statistics of the Ministry of Health of Ukraine, the incidence rate in Ukraine was 70.5 per 100 thousand population. Compared to 2014, the incidence rate was 71.2 per 100 thousand population, which is 0.9% less than in the previous year. However, it should be noted that in 2014, the statistical data included the incidence rate throughout Donetsk and Luhansk regions, and in 2015, only data on territories controlled by the Government of Ukraine. The combined pathology is 1.5-2 times more common in men aged 30-39 and in women aged 50-55. In most cases, diabetes mellitus precedes tuberculosis, in 15-20% - they develop in parallel, in 20% cases, diabetes mellitus develops against the background of tuberculosis. The form of diabetes, its severity and the treatment performed play a large role in the occurrence of tuberculosis. The decrease in immunity in diabetes mellitus occurs under the influence of impaired metabolism, which is accompanied by hormonal, biochemical and other disorders.
In Ukraine, in 2015, 1,392 cases of combined pathology of tuberculosis and diabetes were registered, of which 1,018 cases of sensitive tuberculosis (men – 601, women – 417) and 374 cases of chemoresistant tuberculosis (men – 239, women – 135).
Chuguyiv branch of the State Institution "Kharkiv Regional Center for Disease Control and Prevention of the Ministry of Health of Ukraine"«