New Article in Press: Diabetes Mellitus, Tuberculosis and the Mycobacteria: Two Millenia of Enigma, by Lawrence Broxmeyer MD

The peculiar relationship and frequent association of diabetes mellitus and tuberculosis has been observed for more than 2000 years, yet the reason for this correlation is, to this day, not known. "Before the discovery of insulin, a diagnosis of diabetes was a death sentence within 5 years," said Lawrence Broxmeyer MD, "and the usual cause of that death was tuberculosis. Despite this, in the 5th century, tuberculosis was already being portrayed as a 'complication' of diabetes, a view little changed to this day, parroting Root's original 1934 description of 'a one-sided relationship': tuberculosis still seen as a common complication of diabetes, while diabetes was thought to be no more common among TB patients than in the population at large. To Nichol's, this was 'not logically tenable' and in his study of 178 otherwise healthy, non-diabetic military men with tuberculosis at Fitzsimmons Army Hospital, one-third had abnormal glucose screening tests. But despite his findings and those of Reaud in New York and others, this was not being recognized elsewhere, and Nichols wanted to know why."

"Nichols concluded", mentioned Lawrence Broxmeyer MD, "that the incidence of diabetes among tuberculosis patients was considerably underestimated and that in tuberculosis patients, diabetes develops quite commonly. Diabetes, he felt, was easy to detect. Tuberculosis and the mycobacteria were not."

"The evidence for a mycobacterial cause of diabetes is mounting rapidly," said Lawrence Broxmeyer MD. "Schwartz and Haas both linked Type-2 diabetes to forms of tuberculosis. And the pancreatic islet amyloid deposits that they found as a by-product of systemic tubercular infection have recently been dissolved by rifampicin, a first line drug against tuberculosis. Engelbach spoke of 'transitory' diabetes in TB and Karachunskii noted changes in carbohydrate metabolism in patients with tuberculosis which commonly led to insulin deficiency with persistent hyperglycemia."

"More importantly," Lawrence Broxmeyer MD continued, "mycobacteria elements have been shown recently not only to cause 'autoimmune' Type-1 diabetes in NOD (non-obese diabetic) mice, but act as a vaccine to stop the inevitable diabetes that would otherwise materialize. The documentation of patient cases where TB has preceded and come before the development of diabetes is extensive yet underplayed and both Lin's and Tsai's studies speak of tuberculosis complicated by diabetes."

"By 1991," Lawrence Broxmeyer MD continued, "2 years before The World Health Organization belatedly issued its first ever global emergency regarding tuberculosis, a disease which is estimated to result in a human death every 10 seconds, a WHO ad hoc committee announced that an apparent epidemic of diabetes had occurred – or was occurring – in adult people throughout the world. The developing countries, as well as the minorities of disadvantaged communities in industrialized nations, particularly in the United States, seemed to be taking the brunt of it. CDC maps for US Diabetes and TB, show, in each case, a predominantly southern US distribution for both diseases, with major inroads along much of the eastern seaboard."

"Coincidentally", reminded Lawrence Broxmeyer MD, "the American Indians have some of the highest diabetes rates in the world, nearly four times greater than other Americans, with 40–70% of American Indian adults aged 45–74 found to have diabetes in a recent screening study in three geographic areas. But it is within this subgroup, that the highest levels of diabetes in the world are found, in the Pima Indians of Arizona."

"Diabetes, however," said Lawrence Broxmeyer MD, was and is not the only problem facing the American Indians and the Pimas. For if Indian diabetes soared, their rate of TB was more than five times greater than that for other Americans, most of their children becoming tuberculin positive by the age of 10 or 15. By 1900, tuberculosis had become the most serious health problem among North American Indians, as well as their leading cause of infectious death. And some of the most dreadful manifestations of tuberculosis susceptibility on record can be found when this group was compelled to change their ancestral ways and live on reservations."

"Runaway epidemics among North American Indians" Lawrence Broxmeyer MD reminded, "such as in Arizona, left in their wake TB mortality rates of up to 9,000 per 100,000, the highest anywhere at anytime, a by product of their confinement to reservations and adopting the white man's diet and way of life. Susceptible American Indians were in the direct path of their European colonizers. The single worst disease present in European cities was tuberculosis and by 1800 it was understood that no other disease was as common, nor as deadly."

"Diabetes has been around since the first century AD," Lawrence Broxmeyer MD concluded, "in a perpetual state of coping and managing. It is time, it is long past time, to cure diabetes. But current models as to its cause are not equipping us to do so."

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Distribution: Med America Research, Lawrence Broxmeyer, Lawrence Broxmeyer MD, Dr. Lawrence Broxmeyer