당뇨병에서의 동반질환 유병률 및 조합유병률
Prevalence of Comorbidities among Patients with Diabetes
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Objectives: The patients with diabetes often have one or more comorbidities. To make a clinical decision for the choice of medicine as well as to manage chronic diseases, understanding individual or combination of comorbidities is necessary. This study aimed to investigate the prevalence of comorbidities in diabetes patients. Methods: The comorbidities was defined to include obesity, hypertension (HTN), anemia, dyslipidemia, liver disease or kidney disease. This study included 212,608 adults with diabetes defined as fasting blood glucose≥126 mg/dL, hemoglobin A1c≥6.5% or individuals who have taken anti-diabetes medication, from 16 health promotion centers in Korea from January 2014 to Decemver 2015. Data was summarized by descriptive analyses on the combinations of comorbidity of condition by subgroups of age and sex. Results: Of the Korean adults with diabetes, 88% had one or more comorbidity. The highest prevalence of individual comorbidity was 50.5% in hypertension, followed 50% in obesity, 47.1% in dyslipidemia, 25.7% in liver disease and 14.8% in kidney disease. Comorbid conditions such as HTN, anemia and kidney disease tended to increase in older age group. Most of individual comorbidities were similaror higherin men except for hypertensionand anemia. In addition, 67.3% of the participants had at least two comorbidities with diabetes. The comorbidity burden of the diabetes patients with obesity and other disease was high; 28.8% in obesity and HTN, 26.0% in obesity and dyslipidemia. Conclusions: There is a high prevalence of comorbidity of two or more diseases including obesity or HTN among diabetes patients. To effectively treat and manage diabetes, there should be careful consideration about the presence of multi-morbidity and approach to health promotion including chronic disease management.
Abstract
Objectives: The patients with diabetes often have one or more comorbidities. To make a clinical decision for the choice of medicine as well as to manage chronic diseases, understanding individual or combination of comorbidities is necessary. This study aimed to investigate the prevalence of comorbidities in diabetes patients. Methods: The comorbidities was defined to include obesity, hypertension (HTN), anemia, dyslipidemia, liver disease or kidney disease. This study included 212,608 adults with diabetes defined as fasting blood glucose≥126 mg/dL, hemoglobin A1c≥6.5% or individuals who have taken anti-diabetes medication, from 16 health promotion centers in Korea from January 2014 to Decemver 2015. Data was summarized by descriptive analyses on the combinations of comorbidity of condition by subgroups of age and sex. Results: Of the Korean adults with diabetes, 88% had one or more comorbidity. The highest prevalence of individual comorbidity was 50.5% in hypertension, followed 50% in obesity, 47.1% in dyslipidemia, 25.7% in liver disease and 14.8% in kidney disease. Comorbid conditions such as HTN, anemia and kidney disease tended to increase in older age group. Most of individual comorbidities were similaror higherin men except for hypertensionand anemia. In addition, 67.3% of the participants had at least two comorbidities with diabetes. The comorbidity burden of the diabetes patients with obesity and other disease was high; 28.8% in obesity and HTN, 26.0% in obesity and dyslipidemia. Conclusions: There is a high prevalence of comorbidity of two or more diseases including obesity or HTN among diabetes patients. To effectively treat and manage diabetes, there should be careful consideration about the presence of multi-morbidity and approach to health promotion including chronic disease management.
참고문헌 (26)
- "WHO Diabetes fact sheets"[URL]
- Korean Diabetes Association, "Diabetes fact sheet in Korea 2018" (2018)
- "OECD stat, health status"[URL]
- Korean Diabetes Association, "Korean diabetes fact sheet 2015" (2015)
- 하경화, "Trends in the Diabetes Epidemic in Korea", Endocrinology and Metabolism, 30(2), pp.142~146 (2015), 대한내분비학회
- Korean Diabetes Association, "Diabetes fact sheet in Korea 2012" (2012)
- Gu K, "Diabetes and decline in heart disease mortality in US adults", JAMA J Am Med Assoc, 281, pp.1291~1297 (1999)
- Oldridge NB, "Prevalence and outcomes of comorbid metabolic and cardiovascular conditions in middle- and older-age adults", J Clin Epidemiol, 54, pp.928~934 (2001)
- Colosia AD, "Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review", Diabetes Metab Syndr Obes, 6, pp.327~338 (2013)
- Bajaj S, "Management of anemia in patients with diabetic kidney disease: a consensus statement", Indian J Endocrinol Metab, 20(2), pp.268~281 (2016)
- Meduru P, "Chronic illness with complexity: implications for performance measurement of optimal glycemic control", J Gen Intern Med, 22(Suppl 3), pp.408~418 (2007)
- World Health Organization, "The Asia-Pacific perspective: redefining obesity and its treatment", pp.17~20 (2000)
- Ministry of Health and Welfare, "Framework act on national health examination 2015" (2015), Ministry of Health and Welfare
- Teljeur C, "Multimorbidity in a cohort of patients with type 2 diabetes", Eur J Gen Pract, 19(1), pp.17~22 (2013)[DOI]
- Luijks H, "Prevalence and incidence density rates of chronic comorbidity in type 2 diabetes patients: an exploratory cohort study", BMC Med, 10(128), pp.1~10 (2012)
- Alonso-Moran E, "The prevalence of diabetes-related complications and multimorbidity in the population with type 2 diabetes mellitus in the Basque Country", BMC Public Health, 14(1059), pp.1~9 (2014)
- Gomis R, "Prevalence of type 2 diabetes mellitus in overweight or obese patients outpatients in Spain. OBEDIA Study", Med Clin (Barc), 142, pp.485~492 (2014)
- Harjutsalo V, "Epidemiology and risk factors for diabetic kidney disease", Adv Chronic Kidney Dis, 21, pp.260~266 (2014)
- Kabakov E, "Prevalence of hypertension in type 2 diabetes mellitus: impact of the tightening definition of high blood pressure and association with confounding risk factors", J Cardiometabolic Syndr, 1(2), pp.95~101 (2006)
- Bralic Lang V, "Prevalence of comorbidity in primary care patients with type 2 diabetes and its association with elevated HbA1c: a cross-sectional study in Croatia", Scand J Prim Health Care, 34(1), pp.66~72 (2016)[DOI]
- Wexler DJ, "Sex disparities in treatment of cardiac risk factors in patients with type 2 diabetes", Diabetes care, 28(3), pp.514~520 (2005)
- Davis JW, "Prevalence of comorbid conditions with aging among patients with diabetes and cardiovascular disease", Hawaii Med J, 70(10), pp.209~213 (2011)
- Ferrannini E, "Diabetes and hypertension: the bad companions", Lancet, 380, pp.601~610 (2012)
- Lin P, "Multiple chronic conditions in type 2 diabetes mellitus: prevalence and consequences", Am J Manag Care, 21(1), pp.e23~e34 (2015)
- Chen H, "Comorbidity in adult patients hospitalized with type 2 diabetes in Northeast China: an analysis of hospital discharge data from 2002 to 2013", BioMed Res Int, 2016(10, pp.25 (2016), 2016)[DOI]
- Shibata M, "Nonalcoholic fatty liver disease is arisk factor for type 2 diabetes in middle-aged Japanese men", Diabetes Care, 30, pp.2940~2944 (2007)