Multimorbidity in people with type 2 diabetes in the Basque Country (Spain): Prevalence, comorbidity clusters and comparison with other chronic patients

Alonso-Morán, Edurne; Orueta, Juan F.; Esteban, Jose Ignacio Fraile; Axpe, J.M. Arteagoitia; González, Ma. Luz Marqués; Polanco, Núria Toro; Loiola, Patxi Ezkurra; Gaztambide, Sonia; Nuño-Solinís, Roberto

doi:10.1016/j.ejim.2015.02.005

Cited by 31 publications

(37 citation statements)

References 23 publications

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“…Regarding directed networks, the analysis showed that both psychosis and schizophrenia precede T2DM (Table 2). Other studies have also found these comorbidities 39,45 . Lifestyle risk factors for diabetes were common in patients with schizophrenia (sedentarism, poor diet, obesity) and atypical neuroleptics have been associated with T2DM 46 .…”

Section: Discussionmentioning

confidence: 72%

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MorbiNet: multimorbidity networks in adult general population. Analysis of type 2 diabetes mellitus comorbidity

Aguado

Moratalla-Navarro

López‐Simarro³

2020

Sci Rep

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Multimorbidity has great impact on health care. We constructed multimorbidity networks in the general population, extracted subnets focused on common chronic conditions and analysed type 2 diabetes mellitus (T2DM) comorbidity network. We used electronic records from 3,135,948 adult people in Catalonia, Spain (539,909 with T2DM), with at least 2 coexistent chronic conditions within the study period (2006-2017). We constructed networks from odds-ratio estimates adjusted by age and sex and considered connections with oR > 1.2 and p-value < 1e-5. Directed networks and trajectories were derived from temporal associations. interactive networks are freely available in a website with the option to customize characteristics and subnets. The more connected conditions in T2DM undirected network were: complicated hypertension and atherosclerosis/peripheral vascular disease (degree: 32), cholecystitis/cholelithiasis, retinopathy and peripheral neuritis/neuropathy (degree: 31). T2DM has moderate number of connections and centrality but is associated with conditions with high scores in the multimorbidity network (neuropathy, anaemia and digestive diseases), and severe conditions with poor prognosis. The strongest associations from T2DM directed networks were to retinopathy (OR: 23.8), glomerulonephritis/nephrosis (OR: 3.4), peripheral neuritis/neuropathy (OR: 2.7) and pancreas cancer (OR: 2.4). Temporal associations showed the relevance of retinopathy in the progression to complicated hypertension, cerebrovascular disease, ischemic heart disease and organ failure.

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Section: Discussionmentioning

confidence: 72%

“…Alonso-Moran et al conducted a study in a large data set of patients with T2DM and found more risk in 21 out of 51 chronic diseases 39 . Our OR values are higher, which might be in part because they included older patients.…”

Section: Discussionmentioning

confidence: 99%

MorbiNet: multimorbidity networks in adult general population. Analysis of type 2 diabetes mellitus comorbidity

Aguado

Moratalla-Navarro

López‐Simarro³

2020

Sci Rep

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“…It is impossible to include experts from every specialty in a consensus process. Therefore, we included a diverse group of specialties, including those that are common in disease clusters, for example multimorbidity is greater in patients with type 2 diabetes [43]. The experts also included several General Practitioners who are key to the management and treatment of multimorbid patients.…”

Section: Social and Community Resourcesmentioning

confidence: 99%

Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS)

et al. 2018

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Patients with multimorbidity have complex health needs but, due to the current traditional disease-oriented approach, they face a highly fragmented form of care that leads to inefficient, ineffective, and possibly harmful clinical interventions. There is limited evidence on available integrated and multidimensional care pathways for multimorbid patients. An expert consensus meeting was held to develop a framework for care of multimorbid patients that can be applied across Europe, within a project funded by the European Union; the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS). The experts included a diverse group representing care providers and patients, and included general practitioners, family medicine physicians, neurologists, geriatricians, internists, cardiologists, endocrinologists, diabetologists, epidemiologists, psychologists, and representatives from patient organizations. Sixteen components across five domains were identified (Delivery of Care; Decision Support; Self Management Support; Information Systems and Technology; and Social and Community Resources). The description and aim of each component are described in these guidelines, along with a summary of key characteristics and relevance to multimorbid patients. Due to the lack of evidence-based recommendations specific to multimorbid patients, this care model needs to be assessed and validated in different European settings to examine specifically how multimorbid patients will benefit from this care model, and whether certain components have more importance than others.

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“…La diabetes tipo 2 podría definirse como un síndrome pluripatológico. De hecho, se ha comunicado que casi el 90% de los pacientes con diabetes tipo 2 en nuestro medio presentan multicomorbilidad 6 , lo que resalta la importancia de realizar un enfoque integral e individualizado de esta enfermedad.…”

Section: Diabetes En Medicina Internaunclassified

Diabetes en Medicina Interna

2019

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Gregorio Marañón, clínico insigne y pionero de la Endocrinología española, afirmó que “quien quiera aprender Medicina, que estudie la diabetes”. Con ello, quería resaltar el carácter multisistémico de la enfermedad, su heterogeneidad clínica y su gran complejidad fisiopatológica. Dicha aseveración sigue plenamente vigente en la actualidad. Lo que Marañón no pudo pronosticar fue el carácter epidémico que la diabetes ha adquirido en pocas décadas, debido a que la pandemia de obesidad y el envejecimiento de la población han incrementado de forma exponencial la prevalencia mundial de diabetes mellitus tipo 2, convirtiéndola en un problema de salud pública de gran magnitud. Actualmente, la prevalencia de diabetes en España es del 14%1 y se predice que aumentará un 22% en las próximas tres décadas, siendo la población mayor de 70 años la que sufrirá un mayor incremento2. Se estima que cada 6 segundos se produce una muerte por causa de la diabetes, en su mayoría por enfermedad cardiovascular3 . Según cálculos de la Organización Mundial de la Salud (OMS), la diabetes provocará en el futuro próximo mayores pérdidas de años de vida que el tabaquismo o el SIDA4. Actualmente, la diabetes es responsable del 12% de los costes sanitarios globales y su creciente impacto económico puede comprometer la sostenibilidad de los sistemas públicos de salud.

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Multimorbidity in people with type 2 diabetes in the Basque Country (Spain): Prevalence, comorbidity clusters and comparison with other chronic patients

Cited by 31 publications

References 23 publications

MorbiNet: multimorbidity networks in adult general population. Analysis of type 2 diabetes mellitus comorbidity

MorbiNet: multimorbidity networks in adult general population. Analysis of type 2 diabetes mellitus comorbidity

Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS)

Diabetes en Medicina Interna

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