TANDEM article in The Lancet

Tropical countries are experiencing a substantial rise in type 2 diabetes, which is often undiagnosed or poorly controlled. Since diabetes is a risk factor for many infectious diseases, this increase probably adds to the large infectious disease burden in tropical countries. TANDEM partners Reinout van Crevel and David Moore, together with Seven van de Vijver, reviewed the literature to investigate the interface between diabetes and infections in tropical countries, including the WHO-defined neglected tropical diseases.

Although solid data are sparse, they found that patients with diabetes living in tropical countries most likely face increased risks of common and health-care-associated infections, as well as infected foot ulcers, which often lead to amputation. There is strong evidence that diabetes increases the severity of some endemic infections such as tuberculosis, melioidosis, and dengue virus infection. Some HIV and antiparasitic drugs might induce diabetes, whereas helminth infections appear to afford some protection against future diabetes. For most tropical infections and for possible biological mechanisms underlying associations with diabetes there are no or very little data. The rise in diabetes and other non-communicable diseases puts a heavy toll on health systems in tropical countries. In their article, the authors also explore the opportunities for shared services (e.g. for eye health, ulcer care or renal support) and argue that more research into  the interaction of diabetes and infections in tropical countries is needed.

Find the article here.