Patients who test positive for diabetes at government facilities will now also be referred to undergo examination for tuberculosis.

The new guideline was recently framed by the central TB division after studies showed that people with diabetes have 2-3 times higher risk of contracting TB. At present, under the revised national tuberculosis control programme (RNTCP), TB patients are asked to check their sugar levels too. Through the new framework, health officials hope to detect more TB cases.

“Our estimation of people suffering from the bacterial infection is 22 lakh, but we are able to reach only 14 lakh patients. We don’t know if the ‘missing’ population is getting the right diagnosis and treatment,” said Dr Sunil D Khaparde, deputy director general in the ministry of health and family welfare, who also heads the central TB division.As a pilot project, the new framework was implemented in 100 districts across India.

Dr Khaparde, who was in the city to deliver the 31st edition of Professor Viswanathan Medical Oration on Sunday , said the guidelines will be followed by all government facilities with the RNTCP setup.

A recent study by Dr Vijay Viswanathan, chief diabetologist at M V Hospital for diabetes, and University of Massachusetts Medical School, found that 54.1% of the 209 patients they surveyed with pulmonary tuberculosis were diabetic, while 21% were prediabetic.

“According to data, every fourth person has latent TB, which surfaces when the immune system is weak,” said Dr Viswanathan. Diabetes, he explained, increases the risk of progression to active TB disease in people infected with Mycobacterium tuberculosis, the bacteria that causes TB.Conversely, TB has an effect on diabetes. It can not only worsen blood sugar control but also complicate clinical management of diabetes.