Diabetes dilemma: older people with diabetes face a heavy burden from co-existing health ...( ANN ARBOR Mich. As if diabetes were...),Health

ANN ARBOR, Mich. As if diabetes werent enough to handle, a new study shows that 92 percent of older people with the disease have at least one other major chronic medical condition and that nearly half have three or more major diseases besides their diabetes.

The sheer number, and the severity, of these other conditions appears to decrease patients ability to manage their diabetes. The type of co-existing condition also matters, as diabetes self-care lags most among patients with conditions that they think arent related to their diabetes.

The new findings make it more important than ever, the researchers say, for doctors to treat the whole person by helping diabetes patients learn how to deal with their other conditions in ways that will also allow them to control their diabetes.

The study, published online ahead of print in the December issue of the Journal of General Internal Medicine, uses data from a nationally representative sample of 1,901 adults with diabetes who were age 55 or older in 2002.

The researchers, from the University of Michigan Health System and the VA Ann Arbor Healthcare System, looked at the influence that a range of medical conditions had on the participants ability to manage their diabetes, whether or not those conditions were physically linked to diabetes. For one condition, heart failure, they also assessed how the severity of another condition affected diabetes management.

The data were drawn from the Health and Retirement Study, a major study of older Americans based at the U-M Institute for Social Research and funded by the National Institutes of Health. The current research was funded by VA and NIH.

Patients are dealing with these issues day to day, and theyre affecting the way people prioritize and manage their own self-care, says first author Eve Kerr, M.D., MPH, of the VA and UMHS. Meanwhile, we physicians talk to patients about their diabetes, but not about how their
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