How Comorbid Conditions Can Affect Your Diabetes Care

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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 conditions may be physical or mental in nature. For example, hypertension (high blood pressure) is a common comorbidity of type 2 diabetes—this means hypertension and diabetes often occur at the same time.

Comorbidities are more common than not. About 80% of Medicare spending is for patients that have four or more coexisting chronic conditions. With two or more comorbidities, the term multimorbidity is used, especially if it isn't clear as to which is the primary condition or index condition. Multimorbidity means that multiple chronic or acute diseases and medical conditions are present within one person, without designating one as the primary condition.

Oftentimes comorbidities occur because they share risk factors and may have the same root cause. For example, someone who is obese is at an 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

Today, nearly 98% of adults with type 2 diabetes have at least one comorbid chronic disease and up to 90 percent have at least two.

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 for diabetes can also raise risks of certain types of cancer.

We'll review the most common comorbidities in children and adolescents with type 2 diabetes below.

Obesity

Obesity is characterized by an abnormal or excessive amount of body fat accumulation that negatively affects health. It's important to remember that comorbidities aren't necessarily symptoms of the primary condition, but may still be very closely related. Obesity may lead to diabetes or may simply occur in conjunction with diabetes.

Hypertension

High blood pressure, or hypertension, is a condition in which your blood pressure regularly measures above 130 mmHg systolic and 80 mmHg diastolic. Researchers have found that up to 75 percent of people with diabetes also have hypertension, and those with hypertension alone often show signs of insulin resistance. Thanks to overlapping risk factors, such as sedentary lifestyle and being overweight, the two conditions are highly intertwined.

Dyslipidemia

Marked by an abnormal (usually elevated) level of blood lipids (fatty acids), dyslipidemia can be related to LDL cholesterol, HDL cholesterol, triglyceride levels, or a combination of these markers that are outside normal parameters. Dyslipidemia may be genetic and/or related to lifestyle factors. It shares many of the same risk factors as diabetes and is a highly common comorbidity.

Nonalcoholic Fatty Liver Disease

A condition marked by elevated liver enzymes, abnormally high levels of fat in the liver, and enlargement of the organ, the severity of nonalcoholic fatty liver disease increases with obesity and abdominal fat and may develop as a result of or alongside type 2 diabetes.

Obstructive Sleep Apnea

Sleep apnea is a chronic breathing disorder in which you stop breathing for very short periods of time while sleeping. It may be caused by a partial airway collapse due to excess weight or obesity. Diabetes is considered a risk factor for sleep apnea, but it may also be a comorbidity.

Preventing Comorbidities in Diabetes

Nowadays, diabetes often doesn't exist in isolation. 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
  • Controlling your blood sugar levels
  • Getting adequate sleep
  • Reducing stress and inflammation in your body

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

Managing Comorbidities in Diabetes

If you have a comorbid condition, be sure that your doctors are working together, so your diabetes management is considered alongside the treatment of the comorbid conditions. Your primary care doctor and/or a certified diabetes educator can help to coordinate this care. It is very important for all your providers to be up to date on your current medications, bloodwork, and treatment schedules.

Lifestyle changes can also be incredibly helpful for treating the root cause of the comorbidities, as they're often closely tied. It's never too late to make lifestyle changes to better control your blood sugar. If you need help starting a healthy eating or exercise regimen, don't be afraid to seek out professional help from a nutritionist, dietitian, or certified diabetes educator.

In addition, make sure you're listening to your body and working to reduce stress, get proper sleep, stay hydrated, and incorporate daily movement and stretching so that your body's natural healing processes can function at their best.

A Word 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.

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. 

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