Diabetes dilemma: older people with diabetes face a heavy burden from co-existing health ...(e director of the VA Health Services Res...),Health

Kerr co-directs Quality Improvement for Complex Chronic Conditions, a joint U-M/VA research program directed by John Piette, Ph.D., senior author of the new paper. Together with other U-M and VA researchers, they are studying the issues that face patients who have multiple conditions, and their caregivers. Theyre also devising tools to help assess and improve care for such patients.

The new study was performed to get a representative picture of how many older people with diabetes also have multiple other conditions, and how those other conditions affect them. Thirty percent of the study participants were aged 55 to 64 when the study began; the rest were age 65 or older. Nineteen percent were African-American; 53 percent were women. One-quarter used insulin.

In all, the researchers found that 39 percent had at least one condition that resulted from the damage that diabetes can cause to tiny blood vessels and therefore to nerves, eyes and kidneys. These microvascular conditions are often emphasized in diabetes management plans.

Meanwhile, 81 percent had at least one of the macrovascular problems that are aggravated or triggered in part by diabetes, including high blood pressure, coronary artery disease, a history of stroke or mini-stroke, or heart failure. The researchers also looked at three unrelated diseases. Ten percent also had a lung disease, 14 percent also had cancer, and 55 percent also had arthritis.

The new results show that doctors need to work closely with diabetes patients who have other chronic conditions, to set the priorities for self-care at home. This includes diabetes-related tasks such as taking medication
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