March 25, 2013

Assessment of Common Comorbid Conditions

When talking about two diseases that occur together, I have some real questions about the purpose of the listing the American Diabetes Association (ADA) published in their 2013 guidelines. The first one is more linked to diabetes because of small blood vessel damage in unmanaged diabetes. I understand the researchers finding conflicting evidence when they don't separate type 2 people by age and don't do age-adjustments. If they are including hearing loss as a common disease with diabetes until there is more proof, then maybe this could be a good thing. Except that this is only the second year they have done this for any of the comorbid conditions.

Prior to 2012, this section did not exist as it is. In 2012, the following were listed:
1. Hearing impairment,
2. Obstructive sleep apnea,
3. Fatty liver disease,
4. Low testosterone in men,
5. Periodontal disease,
6. Certain cancers,
7. Fractures, and
8. Cognitive impairment.

Then for the 2013 guidelines they added depression, almost as an afterthought.

I am concerned about the fact that some of these accompanying diseases that have links to diabetes being listed as comorbid conditions. I realize the links to two of the above are disputed (#1 and #8), but I had thought that depression was a strong link. The rest I can agree need listing as accompanying diseases or comorbid conditions.

Either way, those of us with diabetes need to be aware these and take care of ourselves to prevent or treat these conditions. Many of us do have these conditions so knowing this is definitely a help. I have written about sleep apnea because I have this. At present, I don’t know of any cancers, but I do have fatty liver disease.

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