Comorbid Conditions and Diabetes

What are They and How Can They Effect Your Diabetes Care?

Mature female patient in exam room with doctor
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A comorbidity is a disease or condition that coexists with a primary disease, but also stands on its own as a specific disease. The comorbidities may be physical or mental conditions. For example, someone can have hypertension (high blood pressure) and not have diabetes. But on the other hand, someone with diabetes very often has hypertension as well. So, hypertension is a common comorbidity of diabetes.

Comorbidities are more common than not. About 80% of Medicare spending is for patients that have four or more chronic conditions at the same time. It is easy to see why having comorbidities adds to the cost of care. Each patient is likely seeing four specialists in addition to their primary care physician, each prescribing a variety of treatments and drugs and requiring appointments, examinations, imaging procedures and laboratory tests. Then this must all be coordinated by the primary care physician. These are very expensive patients to the system.

The term multimorbidity is also used, especially if it isn't clear as to which is the primary condition or index condition. It means that multiple chronic or acute diseases and medical conditions are present within one person, without designating one as the index condition.

Sometimes comorbidities occur because they share risk factors and may have the same cause.

For example, someone who is obese is at increased risk of developing diabetes. Sometimes the comorbid condition is more likely to occur as a consequence of having the primary condition, such as renal failure developing in people with diabetes.

Comorbidities in Diabetes

The most common comorbidities in children and adolescents with type 2 diabetes are hypertension, dyslipidemia, and nonalcoholic fatty liver disease.

Most adults with diabetes have at least one comorbid chronic disease and up to 40 percent have at least three. Up to 75 percent of adults with diabetes also have hypertension. Other common comorbidities of diabetes are hyperlipidemia, cardiovascular disease, kidney disease, nonalcoholic fatty liver disease, obstructive sleep apnea, and obesity. The risk factors of diabetes can also raise risks of certain types of cancer.

Managing Comorbidities in Diabetes

If you have diabetes, you can reduce your risk of developing comorbidities by modifying the lifestyle factors that put you at risk. This includes controlling your body weight to prevent obesity, stopping smoking, getting enough physical activity, and controlling your blood sugar levels.

Get regular medical check-ups and complete all of the health screenings that are recommended. These can identify conditions earlier in their development and may prevent full-blown diseases. Preventative medical services are included in health plans—you can always call your insurance to confirm what coverage you have.

If you have a comorbid condition, be sure that your doctors are working together, so your diabetes management is considered in the treatment of the comorbid conditions.

Your primary care doctor or certified diabetes educator can help to coordinate this care. It is very important for all your providers to be current on your medications and treatment schedules.

A Note From Verywell

Having diabetes increases your risk for other comorbidities, but that doesn't mean you will definitely get diagnosed with one. Getting regular check-ups can help you intervene early if necessary. In addition, keeping your body weight and blood sugars within normal limits can help to reduce your risks. You can control certain factors, such as, diet, exercise and smoking cessation. If you need help starting a healthy eating or exercise regimen, don't be afraid to seek out professional help.

Most people with diabetes have nutrition and diabetes self management education coverage in their insurance plans. If you have any questions, contact your primary doctor for referrals or more information. 

Sources:

Valderas JM et al. "Defining Comorbidity: Implications for Understanding Health and Health Services." Ann Fam Med. 2009 Jul; 7(4): 357–363.

Rita Rastogi Kalyani, et. al. "Association of Diabetes, Comorbidities, and A1C With Functional Disability in Older Adults Results from the National Health and Nutrition Examination Survey (NHANES), 1999–2006." Diabetes Care May 2010 vol. 33 no. 5 1055-1060.

John D. Piette, PHD and Eve A. Kerr, MD, MPH "The Impact of Comorbid Chronic Conditions on Diabetes Care." Diabetes Care March 2006 vol. 29 no. 3 725-731.

Medha N. Munshi, MD. " Managing Common Diabetes Comorbidities: Going Beyond Standard Care." Physicians Weekly, Nov 13, 2012.

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