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Can Diabetics Take TB Medicines?

Posted on Thu, 6 Mar 2014

Question: My father is 67 yrs old and he is a diabetic since 10 years. 3 months ago, he had a mild heart attack. Now that problem is solved but doctors are suspecting TB. So can diabetics can take TB medicines?

Answered by Dr. Vidya KR (1 hour later)

Brief Answer: Insulin. Detailed Answer: Hi thanks for using HCM. I went through the query and understood your concern. I also appreciate the care you are taking for your father. Your father if diagnosed as suffering from TB then he has to start medications for TB and few adjustment in anti diabetic drugs. Usually for my patients I advice Insulin during the treatment for tuberculosis. Insulin is the best choice of drug. Tight glycemic control is recommended in TB patients. If your father don't want to take insulin injections then drugs like sulfonylureas (eg. glimeperide) need to be adjusted (dose should be increased) with rifampicin and INH can worsen peripheral neuropathy and hence regular followup and vitamin supplement is required. The adjustment is based on sugar levels. So better is to shift to Insulin therapy and to take anti TB drugs. Hope this information helps you. Feel free to ask if any related query and I will be glad to answer them. Wish you and your father a very happy life and good health. Regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Vidya KR (4 hours later)

Hello doctor, Thanks for your valuable advice. I have one query, My father's sugar level is: Before food: 85mg/dl, After food: 163mg/dl. Blood urea: 15.5mg/dl. Serum creatinine: 0.80mg/dl. AEC: 248 cells/cmm. Glycosylated haemoglobic(HbA1C): Result:9.5%. Medicines he is taking for diabetes: Humalog Insulin injection mix 25(Morning:28 units, Evening: 8 units) Gluconorm G2(2 Tablets daily). For Heart problem, he is taking: Clopivas AP150(0-1-0). Metalor XR 25(1-0-0). Angispan TR 2.5mg(1-0-1). Lasilactone 50(1/2-0-0). Aztor 40(0-0-1). So my query is if he takes the below mentioned TB medicines, should the insulin units be varied or he can take the same dosage of insulin? Rimactazid 450mg(1-0-0). Pyzina 500mg (0-2-0). Combutal 800(0-0-1). Kindly advice. Thank you.

Answered by Dr. Vidya KR (21 hours later)

Brief Answer: Insulin dose adjustment required. Detailed Answer: Hi Rajanin, Thanks for follow up query. Yes, definitely you need insulin dose adjustment. As your HbA1c is more than 7 and after food blood sugar is 163, which signifies poor control of blood sugar levels in past 3 months. During any infection insulin requirements slightly increases. So need to adjust insulin. Need not to worry adjustment in insulin and treatment for infection will definitely helps in sugar control . I usually adjust insulin dose based on FBS, PPBS and before lunch blood sugar levels. Hope this information helps you. Feel free to ask further related query. Wish you a good health. Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Vidya KR (2 hours later)

Hello Doctor, Thanks for the advice. Can you please tell me what should be the dose of insulin that is most suited if he takes the medicines I mentioned in my last message. If there is need for any test to be done, Kindly let me know. I will get the test done and will let you know the result. Kindly advice. Thank you.

Answered by Dr. Vidya KR (22 hours later)

Brief Answer: FBS, PPBS and before lunch blood sugar levels Detailed Answer: Hi, Thanks for follow up query. I usually adjust Insulin dose based on blood sugar levels. Get FBS, PPBS and before lunch blood sugar levels. Depending on these values i can adjust insulin dose. Get back to me with these test values. Hope this helps you.feel free to ask further related query. regards

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Above answer was peer-reviewed by : Dr. Vaishalee Punj