ContextTuberculosis (TB) remains a major health challenge in India, with the country bearing the highest global burden. Co-existing with this epidemic is the surge in diabetes mellitus (DM) cases, earning India the title of "Diabetes Capital." AimThis study investigates the association between TB and DM, focusing on the feasibility and outcomes of screening TB patients for diabetes. It also explores the challenges and opportunities for integrated care of TB-DM comorbidities. Settingsand Design: This cross-sectional study was conducted in 32 tuberculosis units in the BBMP district of Bengaluru, Karnataka, India. Materials and methodsData were collected from TB laboratory registers and through interviews with National Tuberculosis Elimination Program (NTEP) healthcare providers. The study assessed the implementation of diabetes screening, challenges in the process, and suggestions for improvement. ResultsAs part of the Quantitative data, of the 17,052 presumptive TB cases examined, 41% were aware of their diabetes status. Diabetics constituted 14.61% of the presumptive cases. Of the diagnosed TB patients, 25.2% were found to be positive for DM as well. Qualitatively, healthcare providers highlighted operational challenges, mainly concerning the timing of blood sugar testing and the need for referral to higher-level facilities. They also emphasized the importance of generating awareness among communities and training healthcare workers for on-the-spot diabetes screening. ConclusionThe findings highlight the urgent need for improved screening of TB patients for diabetes, timely initiation of anti-diabetic treatment, and comprehensive healthcare services under one roof. Advocacy, communication, and social mobilization strategies should be intensified to create awareness of TB-DM comorbidities in the general population.