A double burden of tuberculosis and diabetes mellitus and the possible role of vitamin D deficiency

Qiuzhen Wang*, Aiguo Ma, Evert G. Schouten, Frans J. Kok

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Tuberculosis remains a major global health challenge, particularly in low-to-middle income countries such as China. At the same time, the country is facing a rapidly increasing diabetes incidence over the last 10 years. Diabetes aggravates the tuberculosis epidemic which poses a serious challenge in public health. In recent years, the high prevalence of vitamin D deficiency represents a global health problem, which is also associated with the risk of diabetes, and tuberculosis. Therefore, this review aims to provide an overall and updated understanding of the epidemiology of co-occurrence of tuberculosis and diabetes in China, and to elucidate the possible role of vitamin D deficiency. In conclusion, significant aggravation of the tuberculosis epidemic due to diabetes may exist in China for a relatively long period of time to come. Further, the double burden and its implications to public health in this country may be significantly influenced by the high prevalence of vitamin D deficiency. Bidirectional screening for tuberculosis and diabetes is recommended, and extra vitamin D may benefit especially in a situation of a heavy tuberculosis burden combined with prevalent vitamin D deficiency. Longitudinal studies to verify the role of vitamin D deficiency in the double burden, and trials on the effect of vitamin D supplementation are needed in the future.
Original languageEnglish
Pages (from-to)350-357
JournalClinical Nutrition
Issue number2
Early online date6 Sep 2020
Publication statusPublished - Feb 2021


  • Diabetes mellitus
  • Double burden
  • Epidemic
  • Immunity
  • Tuberculosis
  • Vitamin D deficiency


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