Journal Article

Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study

Mata-Cases, Manel, Real, Jordi, Franch-Nadal, Josep, Cedenilla, Marta, Mauricio, Didac

2019

Overview

ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.DesignA cross-sectional study.SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.Primary and secondary outcome measuresWe collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10th Revision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.ResultsA total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.ConclusionPatients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Aged / Aged, 80 and over / Blood pressure / Cardiovascular disease / Cardiovascular Diseases - epidemiology / Cholesterol / Chronic illnesses / Comorbidity / Cross-Sectional Studies / Diabetes / Diabetes and Endocrinology / Diabetes Mellitus, Type 2 - drug therapy / Diabetes Mellitus, Type 2 - epidemiology / Diabetes Mellitus, Type 2 - metabolism / Diabetic retinopathy / Female / Gestational diabetes / Glycated Hemoglobin - metabolism / Health care / Heart failure / Humans / Hyperlipidemias - epidemiology / Hypertension / Hypertension - epidemiology / Hypoglycemic Agents - therapeutic use / Information systems / Kidney diseases / Kidney Failure, Chronic - epidemiology / Laboratories / Male / Middle Aged / Mortality / multiple chronic conditions / Multiple Chronic Conditions - epidemiology / Obesity / Obesity - epidemiology / Patients / Population / Population-based studies / Prevalence / Primary care / Renal Insufficiency, Chronic - epidemiology / Risk factors / Spain - epidemiology / Trends / type 2 diabetes / Urinary tract diseases / Urinary tract infections / Urogenital system