World Leprosy Day

When you hear “diabetes” and “leprosy,” they likely sound worlds apart, one is a modern chronic condition managed with insulin and lifestyle changes, the other an ancient disease often misunderstood and heavily stigmatised. But emerging research tells a different story, one of unexpected overlap, shared complications, and crucial opportunities for integrated healthcare.

Two Diseases, One Overlooked Link

Multiple studies have uncovered a surprising correlation: people with leprosy are significantly more likely to develop diabetes than the general population.

A study in Kuwait found that 13.3% of leprosy patients had diabetes, compared to 0% in a matched healthy control group (Al Qattan et al., 2012).

In India, another study revealed that 37.7% of leprosy patients had prediabetes, and 20% of those with lepromatous leprosy were diabetic (Gupta et al., 2011).

Furthermore, 23.5% of patients developed glucocorticoid-induced diabetes mellitus (GIDM) due to treatment with steroids like prednisone, commonly used to manage leprosy-related inflammation (Gupta et al., 2011).

This raises a red flag, especially in regions where both diseases are endemic. Co-screening for these conditions isn’t just smart, it could be life-saving.

Peripheral Neuropathy: A Common Enemy

One of the most debilitating consequences of both diabetes and leprosy is peripheral neuropathy, nerve damage that results in numbness, especially in the feet. This leads to unnoticed injuries, chronic ulcers, infections, and sometimes amputation.

What’s compelling is that foot care techniques developed for leprosy, like protective footwear, wound care, and nerve stimulation therapies, have proven valuable in treating diabetic foot ulcers too (Bhat et al., 2012).

Shared solutions can save lives. The healthcare community can benefit immensely from cross-disease learnings like this.

Immunosuppression: Two-Fold Vulnerability

When diabetes and leprosy co-occur, the body’s immune defences are significantly compromised.

In one particularly rare and severe case, a patient with both conditions developed cerebral aspergillosis, a serious fungal infection that spread to the brain. This case highlighted the need for extra caution and monitoring in immunocompromised patients with dual diagnoses (Annamalai et al., 2014).

Healthcare providers must be aware of this layered vulnerability and consider broader screening protocols and patient education.

Double Burden: The Weight of Stigma

Beyond physical health, both diseases come with heavy social stigma, leading to shame, isolation, and reduced participation in community life.

A study in Indonesia compared the social impact of both diseases and found:

• 71% of former leprosy patients experienced participation restrictions.
• 39% of diabetic patients also reported social barriers and exclusion.
• Common experiences included feeling rejected, losing social roles, and developing a sense of inferiority (Van ‘t Noordende et al., 2014).

This suggests that stigma-reduction strategies and inclusive social interventions should target not just one but multiple chronic conditions that isolate people.

A Stronger Case for Integrated Care

The medical, psychological, and social overlap between diabetes and leprosy makes a strong case for integrated healthcare models. It’s time to break the silos.

Imagine a rural health centre where leprosy treatment comes with routine diabetes screening. Or a diabetes support group that includes education on detecting leprosy signs.

Research supports this vision. A report from Leprosy Review called for the formation of joint self-care groups for people with different diseases, particularly those facing similar stigma and complications (Van Brakel et al., 2002).

These integrated approaches don’t just improve outcomes, they also save time, money, and human dignity.

What Can You Do?

• Health workers: Begin routine diabetes screening for leprosy patients, and vice versa.
• Policy makers: Fund programs that address multiple diseases simultaneously and dismantle stigma.
• NGOs and funders: Support integrated outreach and education.
• General public: Learn more. Share what you’ve learned. Push for empathy and inclusivity.

At SOO-DAWI, We Connect the Dots

SOO-DAWI (Stella Oludinanwa Ogbaegbe Diabetes Awareness and Wellness Initiative) is committed to highlighting untold stories, exploring crucial intersections like this one, and creating a world where no one is left behind due to misunderstanding, neglect, or stigma.

Follow us for more insights, collaborate with us to drive awareness, or support our programs to expand wellness across communities that need it most.

Together, let’s bridge the gap.

Sources:

• Al Qattan, M. M., et al. (2012). Prevalence of diabetes mellitus in patients with leprosy. ScienceDirect
• Gupta, M., et al. (2011). Steroid-induced diabetes in patients with leprosy. ResearchGate
• Bhat, R. M., et al. (2012). Use of leprosy foot care for diabetic ulcers. PubMed
• Annamalai, T., et al. (2014). Cerebral aspergillosis in diabetes and leprosy. BMC Research Notes
• Van ‘t Noordende, A. T., et al. (2014). Participation restrictions and stigma in diabetes and leprosy. PMC
• Van Brakel, W. H., et al. (2002). Self-care groups for people with disabilities. Leprosy Review