There is an increased burden of diabetes mellitus (DM) in resource poor setting, coupled with the susceptibility to co-infection with tuberculosis especially in a high endemic tuberculosis (TB) area. Programmatic re-engineering of screening for TB amongst DM patient is needed to ensure a control of an ongoing silent co-epidemic of DM and TB. We report two cases highlighting the importance of screening for TB among patient living with DM. Each case had a peculiar characteristic highlighting the role of TB screening in DM patients and poor outcome of TB in DM patients. Case 1 is a 32 years old nurse with uncontrolled DM, glycated haemoglobin (HBA1C of 16.1% on maximum dose of oral hypoglycaemic agents who presented with night sweat, fever, weight loss and left sided chest pain of two weeks duration. She had a negative sputum geneXpert for acid fast bacilli (AFB), a chest radiograph was suggestive of left sided pleura effusion which responded to TB treatment. Case 2 is a 45 year old female with uncontrolled DM who had associated complication of DM. She was diagnosed as PTB by sputum geneXpert sensitive to rifampicin, however by 5th – 6th month of therapy she presented with recurrent cough, fever and night sweat. Sputum AFB geneXpert was positive for AFB but resistance to rifampicin. Undertaken TB screening among DM patient into clinical practise needs to be intensified in other to improve the outcome of both tuberculosis and control the epidemics.
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