Manejo integrado de tuberculose e diabetes: uma revisão integrativa

OBJECTIVE. To identify the evidence regarding the co-management of tuberculosis and diabetes available in the literature for the Latin-American context. METHOD. An integrative literature review was performed in the LILACS, Web of Science, and PubMed databases. The search strategy employed the terms “tuberculosis”, “diabetes mellitus,” and “integrated management.” Open access articles reporting studies performed in Latin America, published from 2011 to 2017 in English, Spanish or Portuguese were included. The following information was collected: authors, design, sample, main results, country of study, and year of publication. The studies were also classified according to level of evidence. RESULTS. Twenty studies were included, 60% of which had low level of evidence (level IV). According to these studies, patients with diabetes are at increased risk for tuberculosis, especially those with poor glycemic control. In addition, tuberculosis-diabetes patients have delayed sputum conversion and higher probability of treatment failure and death. The prevalence of tuberculosis-diabetes comorbidity is higher in males. Information about tuberculosis and diabetes is poorly recorded or absent in medical charts or electronic files. The management of tuberculosis-diabetes comorbidity is associated with high cost. The multidisciplinary health care team plays a crucial role in the prevention and promotion of health at all levels of care. CONCLUSION. Bidirectional screening of tuberculosis-diabetes may facilitate the control of these disorders, especially in developing countries and endemic tuberculosis areas.