Diabetes and tuberculosis: analysis of a paradox.

Diabetes mellitus is a known predisposition factor for tuberculosis. However, the cause of such interrelationship is incompletely understood. Diabetes mellitus is characterized by hyperglycemia. Interestingly, glucose has been shown to stimulate NADPH oxidase, the key enzyme involved with respiratory burst in monocytes and macrophages. This glucose-induced genesis of reactive oxygen species via respiratory burst is contrary to the survival strategy of Mycobacterium tuberculosis as an intracellular pathogen in phagocytic cells. To address this paradox, diabetes and tuberculosis are reviewed at the molecular level.