A Narrative Review of Tuberculosis and Diabetes Mellitus: The Double Burden Epidemiology, the Current Moment and the Future

Tuberculosis and diabetes are major global health concerns, with their prevalences projected to increase disproportionately in the low- and middle-income countries (LMICs). The convergence of tuberculosis and diabetes impact is also expected to rise, posing a negative synergism that complicates disease management and outcomes. This review aims to summarise tuberculosis and diabetes double burden epidemiology, the overlap, the current moment and future prospects, including exploration of cost-effective interventions to enhance tuberculosis and diabetes integrated care. A literature search was conducted in PubMed, Embase, African Journals Online and Google Scholar on January 1, 2025, to identify studies published between January 1, 2020, and December 1, 2024, on the double burden of tuberculosis and diabetes, as well as integration models. There were no language restrictions. The diagnostic criteria for tuberculosis and diabetes, as well as the integration models, were aligned with WHO guidelines. After screening abstracts and full texts, 35 articles were included in this review. The double burden of tuberculosis and diabetes presents unique challenges at present, but unlocking potential for new opportunities to transform global healthcare delivery amid the increasing double burden disease phenomenon. Integrating tuberculosis and diabetes care is essential to avoid further strain on the already fragile healthcare delivery systems in LMICs. Integrated care enhances bi-directional screening, promotes a holistic approach of treatment and management, and optimises outcomes for both diseases.