RT Journal Article
SR Electronic
T1 Influence of chronic comorbidity and medication on the efficacy of treatment in patients with diabetes in general practice
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e267
OP e273
DO 10.3399/bjgp13X665233
VO 63
IS 609
A1 Welcome Mkululi Wami
A1 Frank Buntinx
A1 Stefaan Bartholomeeusen
A1 Geert Goderis
A1 Chantal Mathieu
A1 Marc Aerts
YR 2013
UL http://bjgp.org/content/63/609/e267.abstract
AB Background Evidence on the influence of comorbidity and comedication on clinical outcomes in patients with type 2 diabetes mellitus is scarce.Aim To ascertain the effect of five chronic diseases (joint disorder, respiratory disease, anaemia, malignancy, depression) and three chronically used drugs (non-steroid anti-inflammatory drugs [NSAIDs], corticosteroids, antidepressants) on treatment for hypoglycaemia in patients with type 2 diabetes.Design and setting Retrospective cohort study in a variety of practices across Flanders, Belgium.Method A retrospective cohort study was conducted, based on data from Intego, a general practice-based continuous morbidity registry. Multiple logistic regression analysis was used to predict the change in glycosylated haemoglobin (HbA1c) levels related to comorbidity, comedication, and a combination of both in 3416 patients with type 2 diabetes. Adjustments were made for age, sex, and diabetes-treatment group (diet, oral antidiabetic drugs, combination treatment, insulin).Results Concomitant joint and respiratory disorders, as well as the chronic use of NSAIDs and corticosteroids, either separately or in combination, were significantly associated with the worsening of HbA1c levels. Anaemia, depression, malignancy, and antidepressants had no statistically significant influence on the efficacy of treatment for hypoglycaemia.Conclusion The presence of some comorbid diseases or drug use can impede the efficacy of treatment for type 2 diabetes. This finding supports the need to develop treatment recommendations, taking into account the presence of both chronic comorbidity and comedication. Further research must be undertaken to ascertain the effect other combinations of chronic diseases have on the efficacy of treatment of this and other diseases.