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Diabetes dilemma: older people with diabetes face a heavy burden from co-existing health conditions
Date:11/13/2007

heart failure or their hypertension is affecting how they manage their diabetes. These results show that we need to be treating the whole patient, but we dont yet have systems designed to do that.

The competing demands of simultaneous chronic diseases may lead people to neglect the self-care steps that will have the biggest impact over the long run, Kerr says. For instance, if a person with diabetes also has arthritis pain, or shortness of breath from heart failure, and these arent fully addressed, the person may refrain from physical activity. And that in turn means theyll struggle to control their blood sugar or blood pressure which is important to prevent future issues such as stroke.

In general, the more diseases a person had along with their diabetes, the more likely they were to report they were putting priority on conditions other than their diabetes, and the worse they reported they were doing at managing their diabetes through five key self-care steps. Severity also mattered: For the one condition for which the researchers had severity data heart failure diabetes self-care was not diminished among patients in the early, less symptomatic stages, but it was among those in later stages.

Also important, the study found, is whether patients perceive that their other conditions are related to their diabetes. For instance, many people with diabetes still dont realize that their disease puts them at much higher risk of heart disease and stroke. That lack of awareness may mean that they dont put as much emphasis on their blood pressure or cholesterol, when in fact controlling those risk factors can greatly influence the health of a person with diabetes. And indeed, in the current study, diabetes self-care was worse among people who had both diabetes and heart disease.

Thats why a whole-person approach to care is so important, says Kerr, who is an associate professor of internal medicine at the U-M Medical School and associat
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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