What are the Most Common Comorbidities of Type 2 Diabetes?

Diabetes affects over 37 million people in the U.S. with 90-95% diagnosed with type 2 diabetes. Many people diagnosed with this disease also have to juggle care management for multiple health issues. When you are dealing with the presence of two or more diseases at the same time this is referred to as comorbidity.

Comorbidities of Diabetes

When you are diagnosed with diabetes, your doctor may review common comorbid chronic conditions to raise awareness and alert you to symptoms that may require immediate medical attention. Type 2 diabetes comorbidities such as heart disease, hypothyroidism, and respiratory problems are quite common. In fact, the American Association of Clinical Endocrinology (AACE) reported that “only 14% of patients with Type 2 diabetes had no other comorbidities.”

If you are researching diabetes comorbid conditions, be aware of terminology sometimes used interchangeably. For data collection purposes, the Clinical Epidemiology Journal makes a distinction between these terms:

• Multimorbidity: coexistence of two or more chronic diseases
• Comorbidities: medical conditions existing at the time of diagnosis, which may include such diabetes comorbidities as multiple sclerosis (disease of the central nervous system) and sarcoidosis (inflammatory disease that affects organs)
• Complications: conditions that occur following the diagnosis of the main condition, such as retinopathy (diabetic eye disease) or cardiomyopathy (heart muscle disease)

Prevalence of Type 2 Diabetes Comorbidities

Almost 98% of American adults who have Type 2 diabetes have one or more diabetes comorbid conditions, and roughly 90% have two comorbidities, according to a study funded by Merck & Co.

The American Diabetes Association references studies that demonstrate keeping blood sugar, blood pressure and low-density lipoprotein (LDL) cholesterol levels near normal may help prevent or delay complications related to your eyes, heart, vascular system, nerves, gums and teeth, feet, skin and kidneys.

Staying committed to a healthy lifestyle, including balanced nutrition and regular fitness activity, can also help prevent other complications.

Glycemic Control

A relationship exists between blood sugar levels and the risk of vascular complications of diabetes, explains the Journal of Diabetes Complications. Epidemiology studies show that initial intensive glycemic control is associated with lower cardiovascular risk. The goal is to safely achieve blood sugar levels as close to normal as possible.

However, some trials show that intensive glycemic control for older, high-risk diabetes patients can be detrimental in some cases. “In Type 2 diabetes, the goal should be tempered for the time being in patients with shorter life expectancy or coexisting cardiovascular disease or other comorbidities.”

A Diabetes Care article speaks to the inconsistent outcomes of intensive glycemic control, declaring that “glycemic control remains a delicate balancing act.” To maintain blood sugar levels, people with diabetes require education, willpower and decision-making strategies to maintain a safe range of blood sugar levels. But diabetic patients, particularly those using insulin, risk getting hypoglycemia (low blood sugar), which slows the supply of glucose to the brain.

Common diabetes comorbidities

Cardiovascular disease (CVD) is one of the common comorbidities of diabetes. The following are four other diabetes comorbid conditions and complications.

Obesity

You are more likely to develop Type 2 diabetes when you are overweight. One reason is that excess glucose is stored as fat. Cells packed with fat lose the capacity to let glucose in, so the glucose sits in the bloodstream. Your pancreas keeps making insulin to try to help the glucose move, but over time, you overtax the pancreas, and insulin production has to slow down.

Not every obese person develops diabetes, but “you’re about six times more likely to develop Type 2 diabetes than those at a healthy weight,” according to the Cleveland Clinic. The Centers for Disease Control and Prevention (CDC) offers specific guidelines, programs and tools to help people lose and maintain a healthy weight.

Hyperlipidemia

Lipids, which are compounds composed of fats and comparable substances, make up an important part of the living cell. A higher-than-normal lipid concentration in the blood is commonly associated with Type 2 diabetes. The condition may improve with glycemic control but does not typically revert to a normal state.

To treat hyperlipidemia, AKA high cholesterol levels, American Family Physician (AFP) recommends annual screenings, glycemic control and weight loss. If those approaches are not effective, then medication to lower your cholesterol levels may be needed.

Hypertension

According to the Journal of Clinical Hypertension, “up to 75% of adults with diabetes also have high blood pressure, and patients with hypertension alone often show evidence of insulin resistance.” Research results suggest that the best approach to managing diabetes and hypertension is lifestyle intervention, including weight control, exercise and dietary changes.

Eye disorders

Diabetes causes damage to the blood vessels throughout your body, including your eyes. The National Eye Institute describes diabetic retinopathy as “an eye condition that can cause vision loss and blindness in people who have diabetes,” impacting the retina’s blood vessels.

This is the most common reason that people with diabetes lose their vision. When you have diabetes, you are also more likely to develop cataracts and a specific type of glaucoma. Regular eye exams are important for everyone but especially for people with diabetes.

Managing Type 2 Diabetes Symptoms

People with diabetes are encouraged to leverage the support of multiple healthcare providers. This team may consist of a primary care physician, podiatrist, dentist, ophthalmologist, nutritionist, pharmacist and other medical specialists.

The following are examples of objectives you can set to help you manage Type 2 diabetes. Achieving these goals can also help you control and prevent common comorbidities associated with diabetes:

• Follow a regular exercise program
• Maintain a healthy weight
• Try losing a few pounds if you are overweight
• Adhere to an optimal nutrition plan
• Work realistic changes into your lifestyle like controlling portions, buying and preparing wholesome food, and finding activities you can enjoy daily
• Regularly check your blood pressure and blood sugar levels
• Getting a good night’s sleep is important – relaxation exercises can help reduce stress