Multiple morbidity in type 2 diabetes-a consequence of poor disease management?

Andrew English, Paula McClean, Tony Bjourson, Catriona Kelly

Research output: Contribution to conferencePosterpeer-review

Abstract

Multiple morbidity in type 2 diabetes- a consequence of poor disease management?
Andrew English1, Declan McGuigan1, Tony Bjourson1, Catriona Kelly1 and Paula L. McClean1
1. Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, BT47 6SB
Introduction
Type 2 diabetes mellitus (T2DM) management is complex, the condition is progressive and often accompanied by multiple co-morbidities. Heart disease and stroke account for much of the mortality associated with T2DM but other conditions are becoming more prevalent as patients are reaching older age. Advances in HbA1c (A1C) monitoring, anti-diabetic medications and cardiovascular treatments mean that people are living longer with T2DM. For the health service multi-morbidity is complex to manage, positive clinical outcomes require more time than is currently available from routine healthcare visits. The efficient management of T2DM and its co-morbidities is therefore vital in reducing the impact of this disease on the healthcare budget. With increasing T2DM prevalence, and increasing numbers of older individuals with the condition, understanding the burden of co-morbidity is of increasing importance. We assessed the comorbidity profile of an Northern Irish type 2 diabetic population to better understand the frequency of associated conditions in relation to T2DM management.
Methods
We analysed a population-based sample of 500 T2DM participants in the Western Trust. Biochemical, prescription and comorbidity data was obtained from the DIAMOND diabetes database and the Northern Ireland Electronic Care Record (NIECR). Participants were grouped by age and HbA1c levels and comorbidities were coded using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) manual.
Results
The mean age of the sample was 63 years (24% < 55years, 50% 56-70 years and 26% aged 71>years). Twenty nine percent of the cohort had between 3 and 5 comorbidities and 19% had more than 8 comorbidities. Advancing age was associated with progressively more morbidity involving the musculoskeletal, cardiovascular and digestive systems. There was no significant difference in HbA1c between the age groups (64 mmol/mol) at the time of sampling, while LDL significantly declined with age (pDiscussion
These findings demonstrate that glycaemic control of the population sampled was significantly greater than the current HbA1c target of 48mmol/mol, which may account for the level of comorbidity observed. This highlights the need to look more closely at response to diabetes therapy in order to reduce the personal and financial burdens associated with comorbidity.
Original languageEnglish
Publication statusPublished - 10 Sep 2019
EventEuropean Alliance for personalised medicine Congress - Belfast, Belfast
Duration: 27 Nov 201730 Nov 2017

Conference

ConferenceEuropean Alliance for personalised medicine Congress
CityBelfast
Period27/11/1730/11/17

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