According to the World Health Organization, about 8,000 people die of tuberculosis every day worldwide, and about 3 million people die of tuberculosis every year. China has the second highest number of tuberculosis patients in the world, second only to India. About 400 million people in China have been infected with tuberculosis bacteria, and about 10% of those who have been infected will successively develop tuberculosis disease during their lifetime. In terms of diabetes, the International Diabetes Federation estimates that more than 190 million people worldwide are suffering from diabetes, and the number of people with diabetes in China is also increasing dramatically at an alarming rate, and it is estimated that there are currently more than 30 million people with diabetes in China, and China has become the second largest country in the world with diabetes after India (75% of the new diabetes patients are in India, China and other developing countries). Relationship between tuberculosis and diabetes Among the interactions between tuberculosis and diabetes, the impact of diabetes on tuberculosis is more important. According to most literature, diabetes precedes tuberculosis in 3/4 of cases when the two diseases coexist, and in 1/4 of cases when the two diseases are found together, while tuberculosis precedes diabetes in only a minority of cases. There are several reasons why diabetic patients are susceptible to tuberculosis I. The growth and reproduction of tubercle bacilli are favored in a hyperglycemic environment. Second, the fat metabolism of diabetic patients is disturbed and triglyceride levels rise, providing a nutritious environment for the growth of tuberculosis bacteria. Third, diabetic patients often lack vitamin A and vitamin B, thus easily weakening the respiratory resistance and favoring the infection and development of tuberculosis. Fourth, diabetic patients with poor nutrition and low immune function are also susceptible to tuberculosis. Tuberculosis patients with toxic symptoms and nutritional depletion affect the normal functioning of the body, including the islets, and cause malnutrition and atrophy of pancreatic islet cells, which can lead to diabetes. Recent studies have found that certain lymphocytes in the peripheral blood of patients with coexisting tuberculosis and diabetes are significantly higher than normal, and it plays an important role in the development of type 1 diabetes in particular by binding with some cytokines or directly damaging islet cells. The coexistence of tuberculosis and diabetes is like adding insult to injury. The two affect each other, forming a vicious circle and making treatment difficult. Once the coexistence of the two diseases is detected, timely and reasonable treatment is the key, with special emphasis on the control of diabetes mellitus. Patients with tuberculosis combined with diabetes mellitus should not lower their blood sugar excessively when receiving diabetes mellitus treatment, and it is appropriate to control it at about 6.5 mmol/L, otherwise hypoglycemia is likely to occur. The anti-TB regimen based on isoniazid and rifampin should be chosen for the treatment of TB, and the duration of treatment must be more than one year. When the two diseases coexist, the toxic side effects of anti-TB drugs are higher than in patients with TB alone, so adverse drug reactions should be closely monitored. If patients with pulmonary tuberculosis combined with diabetes can be detected, diagnosed and treated early, especially if both diseases can be treated reasonably at the same time, most patients have a good prognosis and patients can maintain a good workforce.