A doctor having a discussion with a diabetic patient.
New research from a UK-based team of physicians is providing a more comprehensive overview of the multimorbidity burden among diabetics versus nondiabetics in real-world settings.
An analysis of more than 650k patients registered across 391 general medicine practices in the United Kingdom, results indicated patients with type 2 diabetes were at a greater risk of cardiovascular and other comorbidities, including osteoarthritis, anxiety, schizophrenia, and respiratory conditions, when compared to their nondiabetic counterparts.
“In addition to cardiovascular conditions, our findings show that among the highly prevalent comorbidities are discordant physical and mental health conditions not broadly reported in literature and United Kingdom and other national diabetes guidelines,” wrote study investigators. “Our study is clinically relevant and can have important clinical and public health implications and inform the development of realistic patient-centered care plans.”
Led by Darren Ashcroft, PhD, professor of pharmacoepidemiology at the University of Manchester, a team of investigators from the University of Manchester sought to compare prevalence of a slew of comorbidities in those with recently diagnosed type 2 diabetes and nondiabetics. To do so, investigators designed a study using data from the Clinical Practice Research Datalink to assess for prevalence of 18 comorbidities.
Specifically, the comorbidities of interest in the analysis were asthma, chronic obstructive pulmonary disease (COPD), hypothyroidism, osteoarthritis, chronic kidney disease (CKD), anxiety, depression, schizophrenia, epilepsy, hypertension (HT), hyperlipidemia, atrial fibrillation (AF), congestive heart failure (CHF), peripheral vascular disease (PVD), myocardial infarction (MI), transient ischemic attack (TIA), stroke, and cancer.
For inclusion in the analysis, participants needed to be at least 16 years of age, have a visit between 2004-2014, and have no clinical record type 1 diabetes. In total, 108,588 type 2 diabetics were identified for inclusion. For the purpose of comparison, participants were matched with up to 5 comparators based on age, gender, and practice type—resulting in a cohort of 528,667 comparators.
Overall, 76.7% of type 2 diabetics and 54.2% of matched comparators had at least 1 of the aforementioned comorbidities and all comorbidities were more prevalent among patients with type 2 diabetics. Follow-up data from 2014 indicated type 2 diabetics were more than twice as likely to develop schizophrenia (OR, 2.38; 95% CI, 1.88-3.01), CHF (OR, 2.12; 95% CI, 1.84-2.43), PVD (OR, 2.01; 95% CI, 1.68-2.40), and MI (OR, 2.13; 95% CI, 1.85-2.46) as their nondiabetic counterparts.
Other comorbidities investigators pointed out other conditions found to be significantly associated with higher odds of depression. Additionally, investigators found osteoarthritis, hypothyroidism, anxiety, schizophrenia, and respiratory conditions were highly prevalent in patients with type 2 diabetes. However, investigators found the increased odds of developing cancer associated with type 2 diabetes did not reach statistical significance.
This study, “Eleven-year multimorbidity burden among 637 255 people with and without type 2 diabetes: a population-based study using primary care and linked hospitalization data,” was published in the BMJ Open.