Comorbid Conditions and Diabetes

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A comorbidity is a physical or mental disease or condition that coexists with a primary disease. Comorbidities ranging from hypertension and obesity to liver disease and sleep apnea are common with type 2 diabetes: A 2016 study of more than 1.3 million people showed that nearly 98% of adults with type 2 diabetes have at least one comorbid chronic disease and almost 90% have at least two (known as multimorbidities).

If you have diabetes, your doctor will likely monitor you closely for signs and symptoms of comorbid conditions that can contribute to your overall health and well-being and have an impact on your treatment.

Common Comorbidities

With diabetes and comorbid conditions, there often is a chicken-or-egg dynamic: Certain diseases can increase the risk of developing diabetes, but at the same time, having diabetes can sometimes develop before a comorbid condition.

Either way, there are several conditions that are closely associated with type 2 diabetes: Regardless of which came first, any comorbid condition can greatly compound the disease

Hypertension

High blood pressure, or hypertension, is a condition in which your blood pressure regularly measures above 130 mmHg systolic and 80 mmHg diastolic. As many as 75% of people with diabetes also have hypertension.

This is not surprising, given the two conditions share many of the same risk factors, including sedentary lifestyle and being overweight. It also is worth noting that people who have high blood pressure often show signs of insulin resistance, which can be a precursor to type 2 diabetes.

Obesity

Obesity is defined as an abnormal or excessive accumulation of body fat 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. According to one recent study, diabetes may also lead to obesity.

Dyslipidemia

This condition is characterized by an abnormal level of lipids (fats) in the blood. This usually includes increased levels of low-density lipoproteins (LDL), the so-called "bad" cholesterol as well as elevated levels of triglycerides.

Dyslipidemia may also involve abnormally low levels of the high-density lipoproteins (HDL) that function to help remove LDL from the blood. 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

Marked by elevated liver enzymes and enlargement of the organ due to an accumulation of fat, the risk of nonalcoholic fatty liver disease (NAFLD) increases with obesity and abdominal fat and may develop as a result of or alongside type 2 diabetes.

NAFLD is a serious concern: If not treated, it can lead to scarring of the liver, an increased risk of liver cancer, or liver failure. Many of the same lifestyle measures that can help to manage type 2 diabetes can also help to reverse nonalcoholic fatty liver disease, including following a healthy diet, increasing physical activity, and weight loss.

Obstructive Sleep Apnea

Sleep apnea is a chronic breathing disorder in which a person stops breathing for short periods of time while sleeping. It may be caused by a partial collapse of the airway 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

If you have diabetes, you can reduce your risk of developing comorbidities by modifying the lifestyle factors that put you at risk, such as:

  • Maintaining a health weight (and losing weight if necessary)
  • Stopping smoking
  • Being physically active
  • Controlling your blood sugar levels
  • Getting adequate sleep
  • Reducing stress

In addition, it's vital to get regular medical check-ups and recommended health screenings. These can identify conditions earlier in their development and may prevent full-blown diseases.

Managing Comorbidities in Diabetes

If you have a comorbid condition, you may be treated by more than one doctor working together. Your primary care doctor and/or a certified diabetes educator can help to coordinate this care. It is important for all your providers to be up-to-date on your current medications, bloodwork, and treatment schedules.

The same lifestyle changes that can help to prevent comorbid conditions from developing alongside diabetes can also be helpful for treating them. 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, seek professional guidance from a nutritionist, dietitian, or certified diabetes educator. Most insurance plans will cover all or some of these services for people with diabetes.

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