1. Do diabetes and tuberculosis have the same etiology? Both diabetes and tuberculosis have received strong government attention in recent years. The main manifestations are the significantly higher incidence of TB in the diabetic population and the significantly poorer outcome. Diabetes therefore not only increases the risk of TB development but also has a negative impact on anti-TB treatment. This is because diabetes causes the patient to be immunocompromised, just as AIDS, malignancy and other diseases cause the body to be immunocompromised or severely damaged leading to the attack of various infectious diseases, including tuberculosis. 2.Does diabetes hurt the lungs? Can it cause tuberculosis? Or is it possible for TB to trigger diabetes? Are there any studies or claims? The damage caused by diabetes is mainly in the form of damage to the large microvasculature and the immune system. Therefore, if high blood sugar is not well and consistently controlled, the blood vessels of each organ, mainly the basement membrane of capillaries, are thickened, which affects alveolar oxygen and carbon dioxide gas exchange, so of course diabetes can damage the lungs. On the other hand, there is a lot of research data confirming that diabetes can impair the cellular and humoral immune functions of diabetic patients, leading to a significant increase in the incidence of infectious diseases, including tuberculosis, and also leading to a significant increase in the incidence of tumors in the diabetic population, so the idea that diabetes induces tuberculosis is valid, and according to statistics, the detection rate of tuberculosis in diabetic patients is more than several times that of the general population ( 259 to 804/100,000 vs. 31 to 111/100,000). The theoretical basis for TB-induced diabetes is not yet sufficient, but it is worth mentioning that when you meet a patient with TB, especially refractory TB, please do not forget that diabetes is an important trigger for TB, and it is not particularly difficult to measure blood glucose as far as the current glucose meter has entered thousands of households, but the key is to think about diabetes. 3.Does the doctor pay much attention to this problem? Are there many patients who come to the clinic like this? The medical staff is still concerned about the combination of diabetes and tuberculosis, but the government has started to pay attention to it. The CDC staff, diabetes specialists and TB specialists are already more concerned about this issue, but medical staff in other specialties need to further increase their training and awareness. China has the highest number of patients with both diabetes and tuberculosis in the world. It is estimated that 1.5 million new cases of tuberculosis are diagnosed in China each year, and 27,000 people die of tuberculosis each year. In August 2011, WHO and the International Union Against Tuberculosis and Lung Diseases (IUATLD) released the “Global Collaborative Framework for the Prevention and Control of Tuberculosis and Diabetes”, which for the first time sets out guidelines for the prevention and control of both diseases. China is the first country in the world to use this framework for two-way screening for diabetes and tuberculosis in its routine health care system. In September 2011, WHO, the Global Alliance to Fight Tuberculosis, the World Diabetes Foundation, the International Union Against Tuberculosis and Lung Diseases and the China CDC collaborated to conduct a two-way screening program for diabetes and TB in 11 hospitals in Shijiazhuang, Jinan, Tai’an and Guiyang, and the program screened more than 9,000 TB patients in six TB hospitals and found that 13% of TB The project screened more than 9,000 TB patients in six TB hospitals and found that 13 percent of TB patients had diabetes, 10 percent of whom were previously aware of their diabetes, and 3 percent of whom were unaware of it. According to the Guidelines for the Diagnosis and Treatment of Tuberculosis designated by the Chinese Medical Association’s Branch of Tuberculosis, diabetes mellitus combined with pulmonary tuberculosis is characterized by exudative cheese, which can be large and bulky, with easy formation of cavities, and is found in the hilar region and lower and middle lung fields. It should be distinguished from acute pneumonia, pulmonary sepsis, and lung cancer. Non-specialist medical personnel may not always understand the clinical features and poor prognosis of diabetes mellitus combined with tuberculosis, and crucially, these populations are often a very dangerous source of infection. 4. Is the usual management of sugar control in diabetic patients with TB different from that of other patients? For diabetic patients with tuberculosis, glycemic control requires more stringent glycemic monitoring at a higher frequency. In particular, it is important to emphasize the importance of self-monitoring of blood glucose because diabetic patients with TB may have symptoms such as poor appetite and weakness that often mask the symptoms of hyperphagia in diabetes, and some hypoglycemic drugs may cause gastrointestinal adverse reactions that may aggravate the symptoms of poor appetite, and the requirement of nutritional support therapy for active TB and the requirement of diabetic diet control may cause a lot of confusion to the physician; therefore, the glucose-lowering regimen for diabetic patients with TB may be preferred. Therefore, the glucose-lowering regimen for diabetic patients with TB may prefer insulin therapy to avoid the adverse effects of glucose-lowering drugs on the GI tract. The frequency of glucose monitoring depends on a combination of factors such as the patient’s age, the presence of risk factors for cardiovascular disease, the patient’s nutritional status, and islet function. The closer the blood glucose target should be to normal, the better. 5. Is the cost of two-way screening for diabetes and tuberculosis expensive? Do patients have to go to different clinics for screening? Screening for diabetes in the TB population is relatively easy and inexpensive because blood glucose meters are now in the home and the cost of a blood glucose measurement is about 10 RMB, while screening for TB in the diabetes population may be more expensive because sputum positivity is not easy to find and sputum positivity does not confirm active TB, and other ancillary tests are needed. In short, the difficulty lies in the diagnosis and differential diagnosis of active tuberculosis, and these tests can be a significant burden for patients, costing as little as $100 or as much as hundreds of dollars or more before the diagnosis is confirmed. Screening for tuberculosis in the diabetic population can be done at the diabetes clinic, and once active tuberculosis is diagnosed, patients should go to a tuberculosis institute for systematic and standardized treatment. Screening for active TB in diabetes should be done in a TB clinic to avoid unnecessary population transmission in general hospitals.