‘People unaware about tuberculosis, diabetes link’

He said that although through Revised National Tuberculosis Program (RNTCP), detection of most cases of tuberculosis was possible; there is no such programme for detection of diabetes.

Zehru Nissa
Srinagar, Publish Date: Aug 2 2015 10:23PM | Updated Date: Aug 2 2015 10:23PM
‘People unaware about tuberculosis, diabetes link’File Photo

Doctors have expressed concern at the low levels of awareness regarding the link between tuberculosis and diabetes in Kashmir and have demanded that more efforts should be put for better detection and management of diabetes in the state.

“The growing numbers of diabetics in Kashmir and mounting evidence regarding people with diabetes being more susceptible to tuberculosis should ring alarm bells,” said Dr Naveed Nazir Shah, HoD Chest Medicine at Chest Diseases Hospital in Srinagar.

He said that although through Revised National Tuberculosis Program (RNTCP), detection of most cases of tuberculosis was possible; there is no such programme for detection of diabetes.

“There is no state or national program that would test people’s sugar levels. However, in case of TB, there is a fair amount of awareness about how cough for more than two weeks needs to be checked,” he said.

Doctors are also concerned about the lack of efforts on part of the J&K Health and Medical Education department to mobilize health campaigns for a better outcome of tuberculosis treatment and diabetes control. “Everyone is working in isolation here. There is no coordination between endocrinologists, physicians, public health analysts and researchers,” said a doctor.

“Moreover,” he added, “what is our health policy? Is it based on our health realities?”

World Health Organisation (WHO) recommends that all people with TB should be screened for diabetes. It also advocates screening for TB in people with diabetes.

A physician said, “These recommendations are more relevant in our setting as we still have a considerable load of tuberculosis, especially in some belts.” He added that researches have proven that people with diabetes who are diagnosed with TB have a higher risk of death during TB treatment and of TB relapse after treatment.

With RNTCP running into rough patches every now and then due to non-payment of salaries of employees in Kashmir, the DOTS centres are also not able to deliver as a result of which the TB treatment regimen also suffers. “What motivation will a DOTS provider have if his salary has not been paid for many months altogether? What obligation does he have to be there for the patient and dispense medicines?” a member of an association of RNTCP employees said.

Doctors warn of the complications in diabetes due to the presence of infectious diseases, including TB. “Proper care for diabetes is imperative for people with TB,” Dr Shah said.

Experts have warned at the costs of lack of interaction between infectious disease experts and life-style disease experts in J&K. “It is a challenge as how to have a smoother and better interaction and break down barriers and to open communication among different groups of public health experts,” a public health expert said.

While National Disease Control Program lays impetus on TB, diabetes is still considered a life-style disease with no governmental scheme or programme addressing it. Non-communicable diseases contribute to 39.1% of the national disease burden against the 24.4 % of the communicable diseases. The draft National Health Policy 2015, envisages including a greater number of non-communicable diseases.