Currently, the disease burden of diabetes and tuberculosis is high in China, with 2010 data showing that the prevalence of diabetes and prediabetes among adults is 9.7% and 15.5%, respectively, and that there are an estimated 1 million cases of tuberculosis nationwide. Previous studies have demonstrated that diabetes not only increases the risk of TB, but also has a negative impact on anti-TB treatment. In late 2011, a project to screen for TB in patients with diabetes was launched. On July 25, Professor Lin Yan, Director of the International Union Against Tuberculosis and Lung Diseases (IUATLD) China Office, and others published two studies, “Screening for tuberculosis in Chinese patients with diabetes” and “Screening for diabetes in Chinese patients with tuberculosis”, showing the feasibility of screening for either tuberculosis or diabetes in both groups of patients, suggesting that a well-integrated platform for tuberculosis and diabetes services could improve the diagnosis and treatment of patients with both diseases. (Trop Med IntHealth. (Trop Med IntHealth. Online July 25, 2012) Screening for tuberculosis in patients with diabetes The study was conducted at five hospitals in Tai’an, Dingxi, Guiyang, Jinan, and Shijiazhuang, China, with support from the World Diabetes Foundation and the World Health Organization. Diabetic patients aged ≥14 years were enrolled in the study and screened for active tuberculosis according to the China NTP guidelines, based on symptoms, sputum smears for antacid bacteria, and chest radiographs. In the three reports from September 2011 to March 2012, 72%, 79% and 68% of diabetic patients were screened for TB each time, respectively. 7 cases were found to have combined TB at baseline, 92 patients (0.6% of patients screened) had positive TB symptoms (cough for more than 2 weeks; night sweats for ≥ 4 weeks; fever for ≥ 4 weeks; weight loss within the previous 4 weeks; suspected extra-pulmonary TB manifestations), and 48 newly diagnosed patients were found to have active TB. manifestations) and 48 cases of newly diagnosed tuberculosis. All patients with TB received immediate antituberculosis treatment except for one patient. The detection rate of TB among diabetic patients was more than several times that of the general population (259 to 804/100,000 vs. 31 to 111/100,000). TB detection rates were higher in health facilities with intensive in-house training, specialized screening staff, and in situ treatment conditions. Screening for diabetes among patients with tuberculosis During the same period, the researchers enrolled 8886 patients with registered tuberculosis from six hospitals in Xinjiang, Gansu and An Ding, Guangzhou, Shandong, and Shenyang, China. At screening, patients were first asked if they had diagnosed diabetes mellitus. If no diabetes was present, random blood glucose (RBG) testing or fasting blood glucose (FBG) testing was performed, and patients with RBG levels ≥6.1 mmol/L were then tested with FBG, and those with FBG levels ≥7.0 mmol/L were referred to the diabetes clinic for confirmatory testing. Of the TB patients examined, 12.4% had diabetes, of which 9.7% had diagnosed diabetes at the time of enrollment. Of the 8023 patients requiring diabetes screening, 99% were eventually screened, and 2.9% and 7.8% were newly detected with diabetes and impaired fasting glucose (IFG), respectively. All but one of the newly detected diabetic patients received specialty care for diabetes. The prevalence of diabetes mellitus was higher among TB patients in urban health services than in rural health facilities (14.0% vs. 10.6%) and higher among those attending general hospitals than in TB specialist clinics (13.5% vs. 8.5%). Investigator’s view Routine screening for active tuberculosis among diabetic patients facilitates early treatment of tuberculosis, reduces tuberculosis transmission, and improves the efficacy of anti-tuberculosis treatment. The implementation of bidirectional screening for both diseases in patients with diabetes and tuberculosis opens the door to collaboration between infectious and non-infectious disease control programs. In the case of diabetes screening among TB patients, although the cost of each blood glucose test is only $1.6 to $1.8, it is also a problem that cannot be ignored for most TB patients from poor communities.