The major problem with type 1 diabetes is that the body produces antibodies that attack the body’s healthy islet cells in the pancreas which produces insulin. This limits insulin production making the body the body unable to make use of glucose gotten from diet leading to high blood sugar. The patient then has to makes rely on insulin injections or pumps to survive.
Before now, several research works have being aimed at transplanting islet cells from deceased donors into the liver but this has not been ideal The liver can only take few islet cells and with risk of bleeding.
Recently, researchers at the University of Miami Diabetes Research Institute have tried another location – the omentum, a fatty membrane in the belly.
A 43 year old single mother with a 25 year history of type 1 diabetes has been off insulin for over a year following islet cell transplant in the omentum. Before the transplant, she was said to have been on about 33 units of insulin per day. No surgical complications were observed during the procedure.
The researchers said
“The cells began producing insulin faster than expected, and after one year she is doing well and doesn’t need insulin injections”.
“We’re exploring a way to optimize islet cell therapy to a larger population. This study gives us hope for a different transplant approach,”
Dr. David Baidal, assistant professor in the University of Miami Research Institute who led the study said. The research is the first step towards developing a mini organ called BioHub.
The BioHub would be like a home to the islet cells providing it with blood supply and nutrition, making it easier to remove in cases of complications. The researchers plan to test the use of omentum as a site in 5 new patients.
Baidal explained that
“Her quality of life was severely impacted. She had to move in with her parents. And, if she traveled, she had to travel with her father”.
This is indeed good news.
This is a step in the positive direction for about 422 million people worldwide living diabetes. It would also markedly save cost for insulin in the long term.
More information of this ground breaking research headed by Dr David A. Baidal can be seen in the New England Journal of Medicine.
Meanwhile, you can win an all expense paid trip to a Diabetes youth camp in Ghana. Click here for details
All medical undergraduates and postgraduates are invited to apply for the
Merck Diabetes Award 2017 Theme: Every Day is a Diabetes Day
Please submit a concept paper about:
How to improve the awareness about Diabetes Early Detection and Prevention in your country.
How to encourage your society, scientific community, local authorities, media and relevant stakeholders to Think and Act on Diabetes Every Day.
Your ideas of developing new policies, strategies, social media campaigns and more.
Merck Diabetes Award 2017
“Postgraduate Diabetes Diploma with University of South Wales. Winners will be invited to attend the Merck Africa Luminary on 24th-25th October, 2017 in Cairo, Egypt to receive the award”.
Merck Diabetes Award is being rolled out in many of the African and Asian universities as part of our commitment to building diabetes capacity and improving access to quality and sustainable healthcare solutions in developing countries.
The aim of Merck Diabetes Award is to create a Diabetes Experts Platformacross the globe.
All medical undergraduates and postgraduates are invited to apply for the
Merck Hypertension Award 2017
Theme:What the Healthy Heart needs
Merck Hypertension Award is being rolled out in many of the African and Asian universities as part of our commitment to building healthcare capacity and improving access to quality and sustainable healthcare solutions in developing countries.
The aim of Merck Hypertension Award is to create a Hypertension Experts Platform across the globe.
To raise the required awareness to control and prevent hypertension, countries need systems, policies and services in place to promote universal health coverage and support healthy lifestyles: eating a balanced diet, reducing salt intake, avoiding harmful use of alcohol, getting regular exercise and stopping the use of tobacco.
Please submit a concept paper about:
How to improve the awareness about hypertension control and prevention in your country.
How to encourage your society, scientific community, local authorities, media and relevant stakeholders to think and act on Hypertension Every Day
Your ideas of developing new policies, strategies, social media campaigns and more.
Merck Hypertension Award 2017 is:
“Postgraduate Diploma in Preventive Cardiovascular Medicine with University of South Wales. Winners will be invited to attend the Merck Africa Luminary on 24th-25th October 2017 in Cairo, Egypt to receive the award”.
The 21st of May was a memorable day for the students of Ogun State as the ministry of health launched its School Health Cadet program.
The School Health Cadets involves cross section of secondary school students from across Ogun State.
Their responsibility is to create a health conscious Community through their various activities in their schools and respective communities.
The Nigeria Diabetes Community partnered with the ministry of health to train the students on Diabetes education and Advocacy with the aim of creating adequate diabetes awareness at community level.
The Honorable Commissioner for Health Dr. Olaokun Soyinka charged the children to be health ambassadors in their communities creating passionate change that will make the communities a safer environment and healthier.
Among distinguished guests present at the launch are the representatives from Ogun State ministry of education, Dangote Groups, Talabi Diabetes Center, Unity Bank, Eli Lilly Pharmaceuticals and The Nigeria Diabetes Community .
A team of 10 participants to include students, a school teacher and school health worker from 10 schools across the 3 geographical zones in the states were trained.
It is expected that the team will translate the knowledge acquired during the training to their colleagues at school and their respective communities.
Followup on their activities will be done through the school health unit of the department of public health.
Our Profound Gratitude goes to everyone who has supported this program and made it a reality most especially the sponsors of the diabeducation project:
Eli Lilly Pharmaceuticals
Mr Olumuyiwa Talabi – Talabi Diabetes Center
Dr Gbadebo Saba – Owokoniran Memorial Hospital
Dr Dunni Osofisan
Dr Okubenna Oladunni
Dr Tosin Ojo
Alhaja R.O Balogun
The burden of Diabetes in resource poor settings are enormous and coupling it with other co-morbidities might not be a very pleasant experience.
A couple of days ago I met a young lady in her early 30s who was recently diagnosed with diabetes. Looking at her facie I requested for her genotype done and was surprised when the result came and she is SS- Sickle Cell Anaemia.
In my 3 years of Advocacy it has never occurred to me a possibility of both conditions coexisting and this lady got me thinking so I decided to conduct a mini research into it.
Sickle-cell disease (SCD ), also known as sickle-cell anaemia (SCA ) , is an inherited blood disorder , characterized by an abnormality in the oxygen carrying haemoglobin molecule in red blood cells .
This leads to a propensity for the cells to assume an abnormal, rigid, sickle -like shape under certain circumstances. Sickle-cell disease is associated with a
number of acute and chronic health problems, such as severe infections, attacks of severe pain (“sickle-cell crisis”), and stroke , and there is an increased risk of death.
According to an article on Medscape, clinical experience in tropical countries with a high incidence of SCD indicates that the concurrence of SCD with either type 1 or type 2 diabetes is a rare finding.
Although there are no population-based data to determine the relative prevalence of diabetes among patients with SCD in the tropics, it seems that the SCD population enjoys relative ‘protection’ from diabetes.
Theoretical mechanisms for such protection would include the low BMI, hypermetabolism, and possibly other genetic factors.
The situation in the tropics might be quite different from that in affluent countries, where blood transfusions are more widely used to palliate the anemia of SCD.
According to this article iron overload due to multiple transfusions can result in β-cell damage and decreased insulin production. The result can range from glucose intolerance to frank diabetes that requires insulin for control.
The analysis revealed that, for every 10 years of transfusion use, transfused subjects with SCD had 2.5-times greater odds of diabetes. The analysis showed, moreover, that transfused patients with thalassemia had 5.2-fold greater odds of diabetes compared with transfused patients with SCD.
But beyond this scientific expose there is need for specialized adequate medical care for people living with diabetes and those who might have other co-existing morbidities such that the burden won’t lead to state of hopelessness, depression and mortality.
Food for thought:
After interacting with her I discovered she is from a middle class family hence she might be able to get her medical supplies but what if she were from a family living below the UN $1 a day poverty benchmark?
What will be her fate?
NGOs and advocates should brace up to stand for equity in medical access across board and a health system that can cater for people in dire need for support and care.
Adejumo Olamide H.
Contact us on email@example.com
Join the Nigeria Diabetes Online Community on twitter @theNGdoc and visit our website and blog www.ngdoc.com and www.ngdocblog.com respectively for more information.
Just One Less Sugary Drink A Day Makes A Difference
A new study on Diabetologia says that every 5% of a person’s daily energy intake that comes from sugary drinks correlates to an 18% higher risk of developing Type 2 Diabetes – that’s almost a 20% greater risk of developing Type 2 Diabetes for ever glass of sugary soda!
“The good news is that our study provides evidence that replacing a daily serving of a sugary soft drink or sugary milk drink with water or unsweetened tea or coffee can help cut the risk of diabetes,” said researcher Dr. Forouhi, adding that this allows them to “(offer) practical suggestions for healthy alternative drinks for the prevention of diabetes.”
The researchers’ analysis of the data, which accounted for a range of factors such as total energy intake, found that soft drinks and other sweetened beverages posed a particularly insidious risk, as opposed to the consumption of natural fruit juice, coffee, or tea.
Currently in Nigeria, the emphasis of most policies and interventions is on screening and early treatment.
Though diabetes education forms a part of most strategies, screening of people at risk is the main focus.
The current strategies that exist in Nigeria are mainly health-care facility based and as such do not provide adequate information to the teeming population.
According to the IDF Diabetes Atlas (2013), about 3.9million out of the 78 million adult population in Nigeria (20-79years) is diabetic.
This puts the National prevalence of type 2 diabetes at approximately 5%. According to the same report, about 105,000 diabetes related deaths occurred in 2013.
There is thus a need for improved diabetes education and awareness
DIABEDUCATION is aimed at imbibing healthy living lifestyle, good physical activities among young individuals as well as make them diabetes advocates in their schools and communities through adequate diabetes education in a “catch them young approach”.
The training manual was developed to teach basic symptomalogy of the disease in easy to understand plain language for children and adults as well as utilizing community focused advocacy methods and via the use of social media- the latest social trend as a veritable tool for diabetes advocacy.
With Nigeria’s mobile subscriber base estimated to grow by a significant 14 percent this year to 120 million, utilization of social media in youth health advocacy will help educate, motivate, encourage, and act as a viable propagation medium for adequate diabetes information and education among Nigerians.
With this project we will be directly training over a hundred secondary school students across Ogun State who will then create awareness and educate their peers and community hence indirectly affecting over a hundred thousand individuals across the state.
Our profound gratitude goes to The Ogun State Government, The Ogun State Ministry of Health and the Department of Public health and School health board for the tremendous support.
We also say a big thank you to the Honorable Commissioner for Health for Ogun State, Dr Olaokun Soyinka, Mr Talabi Olumuyiwa – Patron of The Talabi Diabetes Center, the Directors, Facilitators, Volunteers, Sponsors and finally our contributing authors.
This program is scheduled to hold on the 16th of April, 2015. Follow the hashtag #diabeducation on Twitter and on Facebook.
Interested in being a part of the program either as a sponsor or volunteer? Please send us an email on firstname.lastname@example.org
The 2nd Pan-African Diabetic Foot Study Group Bi-annual Scientific Meeting.
This Bi-annual meeting being the first of its kind in Africa, took place at the conference room of the Blue Pearl Hotel Morogoro Road, Ubungo Plaza, Dar-es-Salaam Tanzania between 24th to 26th August 2014.
It was aimed at providing updated information regarding the prevention and management of diabetic foot complications in Africa, by bringing together a group of international specialist who are well known for their work in the field of diabetic limb complication.
Delegates from 29 countries around the world, 19 African countries out of which 4 Nigerians were in attendance.The scientific conference was fully packaged with twenty-two lectures on diabetic foot by specialists, eight live workshops which focused on various aspect of clinical practice and management of diabetic foot complications, oral and poster presentations by selected delegates.
The PADFSG was created to promote an advancement of knowledge on all aspect of diabetic foot care through active cooperation and collaboration between diabetologist, podiatrist, specialist nurses, orthopaedics and vascular surgeons and all other specialist with an interest in caring for people living with diabetic foot problems.
This collaborative effort will be to bring together, researchers working in this fields to exchange experiences in research and clinical practice during regular meetings. In addition, the PADFSG may also work actively for the promotion of African collaborative studies and also act as a reference group for other groups in matters relating to foot problems, amputation etc.
Diabetes is a serious chronic disease that needs urgent attention. It affects rich and poor,young and old, and industrialized in equal measure. In 2013, the global prevalence of diabetes was estimated at 382 million (20-70yrs) of which 80% live in low and middle income countries. This figure is predicted globally to reach 592 million ( 55% increase) by 2035. In Africa, total number of diabetes was 19.8 million in 2013 and will increase to 41.4 million by 2035. At present, it is estimated that still 190 million people (55%) with diabetes are undiagnosed. At the same time, diabetic foot complication will increase.
Every 20 seconds a limb is lost due to diabetes somewhere in the world. Approximately 15% of all people with diabetes will be affected by a foot ulcer during their lifetime and up to 85% of amputations in relation to people with diabetes are preceded by a foot ulcer. 1 in 4 of diabetes patient with DM foot require immediate amputation and five years recurrence rates of ulcer is 70%.
Research studies have shown that people with one lower limb amputation as a result of uncontrolled diabetes have a 50% risk of developing a serious lesion in the second limb within 2 years. People with diabetes have a 50% mortality rate in the 5 years following the initial amputation. Across the globe, 40-60% of all lower extremity non-traumatic amputations is due to diabetic foot.
The prevalence of diabetic foot among people with diabetes in Nigeria is 55% and mortality is 12%. Globally, up to 70% of all leg amputations happens to people living with diabetes, lower extremely amputations in diabetes count over 1 million per year. Foot complications, especially serious ones like the septic limb can be serious and costly.
85% of all diabetic foot related problems are preventable.
In other to improve diabetic foot care, education and prevention of amputation in Africa, Dr. Z.G. Abass who doubled as the chairman PADFSG and also chairman organising committee of the conference, initiated the “Step by Step Foot Project” in Tanzania in 2004, which was the first in Africa and has due to the successful establishment of its model of diabetic foot care in Tanzania encouraged other countries to do likewise. To date, the model has been exported to various other countries in Africa, Pakistan, Saudi Arabia and the Caribbean.
As part of the step by step foot project, a book “Pocket guidelines of diabetic foot for health care worker” by Dr. Z.G. Abbas was launched on the first day of the conference to provide a broad sweep of current knowledge in the field of diabetic foot complications.
Thus, educating patients and health care workers which is the integral part of any prevention program. The pocket guideline is a useful tool for clinical practice aimed at managing the diabetic foot; it focuses on the key aspect of prevention and education through initiatives based on sharing of knowledge and guidelines for managing diabetic foot.
We want to profoundly appreciate the immense contribution of the PADFSG, particularly Dr Z.G. Abass for the sponsorship of the NGDOC representative to the conference.
Dr Foluke Ajose is a diabetes advocate, NGdoc DiabLink Cordinator interested in Diabetes Limb Salvage, she is currently in talks with Dr Abass towards inviting him to Nigeria and replicating the “Step by Step Foot Project” model in Nigeria.
Next PADFSG Conference holds Oct 14-15th 2016,in Cairo Egypt. Don’t Miss it!
Traditional Display at the Gala dinner
BLUE PEARL HOTEL MAIN ENTRANCE
Delegates at Lunch
Delegates from Nigeria
Dr. Ajose Foluke with Dr. Z.G. Abbass(chairman PADFSG)
Dr. Arun Bal,Founder President Diabetic Foot Society of India
Launching of Book and Opening of the Meeting
Overview of Delegates at the Conference
Prof Andrew Bolton, Founding Chair Diabetic Foot Study Group Of EASD 1998
The Africa Diabetes Congress of the International Diabetes Federation took place at the Palaise de Congress in Yaounde Cameroun from the 25th to the 28 February 2014.
The 2nd African Diabetes Congress appropriately themed: “Diabetes: Challenges and opportunities in Africa” provided an ideal opportunity for researchers, health care providers, practitioners, students, people living with diabetes to cross fertilize with colleagues from Africa and mingle with international renowned experts in the field of diabetes.
About 1,000 participants from about 45 countries were there to raise awareness on diabetes and its impact by convening at the IDF Africa diabetes congress to exchange research and best practices on diabetes prevention, treatment and management.
Cross section of Participants at the ADC2014
The international Diabetes Federation (I.D.F) is the umbrella body organization of over 200 national diabetes associations in over 160 countries. It represents the interests and the growing numbers of people with diabetes and those at risk. The Federation has been leading the global diabetes community since 1950.
Cross-section of participants at the pre-congress post graduate course on Research Methodology/Scientific writing
A Pre-congress update course on Research Methodology/Scientific writing where about 30 young researchers from all over Africa were trained and updated on recent trends in research methodologies and scientific writing.
According to the Chairman organizing committee and former International Diabetes Federation, President Professor Mbanya the young scientists are expected to through the training received translate diabetes research and care in Africa to meet up to global standard.
Discussing the challenges facing diabetes care in Africa over lunch
Simultaneously, a pre-conference update course on Advocacy was running where selected individuals from different countries attended and were trained on how to advocate, engage the government and ensure right policies are effected in their respective countries .
Policy advocacy is one of the most effective ways to achieve public health goals by ensuring that necessary resources, policies and political will are available to support, scale up, and sustain diabetes efforts within broader NCD programs.
Mobolaji Dauda from Nigeria and Pamela Donggo from Uganda at the Update course
We strongly believe that this congress will be one that wont be quickly forgotten as it laid a solid foundation not just for subsequent congresses but also diabetes research, prevention and care in Africa generally.
The 2nd Africa Diabetes Congress was made bilingual through an impressive translation efforts of the Medical Students of the University of Yaounde (a feat that was very professional and commendable).
The Organizers through the efforts of the platinum sponsors were able to sponsor about 600 participants for the congress, a remarkable and great achievement.
With recent announcement of the startoff of the Africa Diabetes Study Group and Africa Diabetes Journal we are rest assured that IDF Africa through the ADC is positioning itself for the task of curbing the diabetes epidermic in the continent.
We wish to appreciate the congress organizers who through the support of El-Lilly were able to fully sponsor 2 members of The Nigeria Diabetes Online Community for the pre-congress update course and congress and also through Servier provided accommodation for 4 members of The Nigeria diabetes online community for the period of the congress.
We believe supports like this is important in not just building young researchers but also inspiring more youths into diabetes care and prevention in their respective communities all over africa.
POST GRADUATE COURSE IN RESEARCH METHODS AND SCIENTIFIC WRITING
SHOWCASING THE RICH TRADITIONAL CULTURE OF CAMEROON
THE OPENING CEREMONY OF THE 2ND AFRICA DIABETES CONGRESS
OPENING CEREMONY WITH THE MINISTER OF PUBLIC HEALTH OF CAMEROON
GUEST LECTURE BY GEORGE ALBERTI (UK)
ONE OF THE SCIENTIFIC SESSIONS
ONE OF THE SCIENTIFIC SESSIONS
PROF MBANYA ADMONISHING THE NGDOC TEAM AT THE LILLY DIABETES CONVERSATION MAP STAND
NIGERIAN DELEGATES TO THE ADC WITH PROF TOM JOHNSON (4TH FROM THE LEFT)
YOUNG RESEARCHERS FROM AFRICA
LILLY HOSTED US TO A DINNER
The next Africa diabetes congress will be hosted by Uganda. UGANDA 2016
Tuberculosis (TB) is an airborne disease caused by infection with Mycobacterium tuberculosis complex (M. tuberculosis, M. bovis, and M. africanum).
Tuberculosis is a major public health problem in many low- and middle-income countries, where the number of people with diabetes is also rising rapidly. Regions, such as Africa and Asia that are most heavily affected by tuberculosis are also those that have some of the highest numbers of people with diabetes, and will experience the biggest increases by 2030.
GROWING DOUBLE BURDEN
Clinicians have observed an association between Diabetes Mellitus (DM) and TB for centuries, as far back as the ancient Roman times, even though they were unable to determine whether DM caused TB or whether TB led to the clinical manifestations of DM.
The growing prevalence of diabetes poses a challenge for TB control as uncontrolled diabetes leads to a greater risk of developing TB. A recent study showed that countries that saw an increase in diabetes prevalence also had a significant increase in the number of people with TB. This suggests that increasing diabetes prevalence could make attainment of the Millennium Development Goals on tuberculosis more difficult to achieve.
These trends reflect the important links between the diseases. Several studies have looked at the association between diabetes and tuberculosis in developed countries and found that people with diabetes are almost 3 times more likely to develop tuberculosis. These findings were also true of developing regions including Africa where one study found that the prevalence (%) of diabetes was twice as high in people with tuberculosis than in people without tuberculosis.
Experimental studies investigating the relationship between Tuberculosis and Diabetes have demonstrated that DM is indeed positively associated with TB. Studies revealed consistent evidence for an increased risk of TB among people with diabetes despite heterogeneity in study design, geographic area, underlying burden of TB, assessment of exposure and outcome, and control of potential confounders. In addition, DM patients have a significantly increased risk of developing active TB, three times higher than in persons without DM.
BATTLE AGAINST TWO
The relationship between DM and TB is bidirectional. These diseases often coexist. Suboptimal control of diabetes predisposes the patient to tuberculosis, and is one of the common causes of poor response to anti-Tuberculosis treatment. Diabetes impacts TB by:
Tripling the rate of developing active TB from latent TB infection
Increasing mortality and severity of disease
Slowing the response to effective TB treatment.
TB and its treatment can worsen glycemic control and diabetes-related neuropathy. Tuberculosis also affects diabetes by causing hyperglycemia and causing impaired glucose tolerance. Impaired glucose tolerance is one of the major risk factors for developing diabetes.
THE DUO TO WORRY ABOUT
At the individual level, the risk of developing TB is considerably lower in persons with DM than in HIV patients. However, the much larger and rapidly growing pool of DM patients makes the global population of persons with TB and DM very similar to that seen with HIV.
In a study conducted on the United States-Mexico border, it was shown prospectively that DM contributed to 25% of TB cases whereas HIV infection contributed to ≤5%; hence as with TB-HIV, we must adapt and apply similar methods of preventing, screening and treating DM-TB patients, and ensure that we have a secure pipeline for drugs that will improve the efficacy of treatment.
WISDOM WAY OUT
The Pacific Standards for Management of Tuberculosis and Diabetes lay out a frameworkfor the bi-directional screening for each disease when one is present, as well as provides guidance on testing, patient support, active and preventive TB treatment. This framework may be useful for other regions, and should be considered for the proper management of TB and DM.
Suggested screening for M. tuberculosis infection can be achieved using QuantiFERON®-TB Gold In-Tube test (QFT®), along with a symptom review for prompt diagnosis and treatment of TB or latentTB infection (LTBI). QFT has been shown to be significantly more accurate than the skin test,only requires one visit, and does not cross-reactwith the BCG vaccine. However QFT or the skin test donot distinguish between Latent TB Infection and active disease, hence active TB must be excluded before starting preventive therapy.
QFT, like the skin test is an indirect test for M. tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography and other medical and diagnostic evaluations. (QuantiFERON-TB Gold ELISA Package Insert, 2013). Clinical assessment is always needed. Hence, active or latent TB should never be diagnosed or excluded on the sole basis of the QFT or skin test result.
This write-up was put together by Akinpelu Akintunde, a final year medical student of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.
The International Diabetes Federation
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Boucot KR, Dillon ES, Cooper DA, Meier P, Richardson R (1952) Tuberculosis among diabetics: the Philadelphia survey. Am Rev Tuberc 65: 1-50.
Nichols GP (1957) Diabetes among young tuberculosis patients; a review of the association of the two diseases. Am Rev Tuberc 76: 1016-1030.
Silwer H, Oscarsson PN (1958) Incidence and coincidence of diabetes mellitus and pulmonary tuberculosis in a Swedish county. Acta Med Scand Suppl 335: 1-48.
Kim SJ, Hong YP, Lew WJ, Yang SC, Lee EG (1995) Incidence of pulmonary tuberculosis among diabetics. Tuber Lung Dis 76: 529-533.
Pablos-Mendez A, Blustein J, Knirsch CA (1997) The role of diabetes mellitus in the higher prevalence of tuberculosis among Hispanics. Am J Public Health 87: 574-579.
Ponce-De-Leon A, Garcia-Garcia Md Mde I., Garcia-Sancho MC, Gomez-Perez FJ, Valdespino-Gomez JL., et al. (2004) Tuberculosis and diabetes in southern Mexico. Diabetes Care 27: 1584-1590.
Alisjahbana B, van Crevel R, Sahiratmadja F, den Heijer M, Maya A (2006) Diabetes mellitus is strongly associated with tuberculosis in Indonesia. Int J Tuberc Lung Dis 10: 696-700.
10. Perez A, Brown HS 3rd, Restrepo BI (2006) Association between tuberculosis and diabetes in the Mexican border and non-border regions of Texas. Am J Trop Med Hyg 74: 604-611.
11. Christie Y Jeon, Megan B. Murray (2008) Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med 5(7): e152.
12. Asfandyar Khan Niazi and Sanjay Kalra (2012) Diabetes and tuberculosis: a review of the role of optimal glycemic control. Journal of Diabetes & Metabolic Disorders 2012, 11:28.