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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/15966

Title: Influence of chronic comorbidity and medication on the efficacy of treatment in patients with diabetes in general practice
Authors: WAMI, Welcome
Buntinx, Frank
Bartholomeeusen, Stefaan
Goderis, Geert
Mathieu, Chantal
AERTS, Marc
Issue Date: 2013
Citation: BRITISH JOURNAL OF GENERAL PRACTICE, 63 (609), p. E267-E273
Abstract: Background Evidence on the influence of comorbidity and comedication on clinical outcomes in patients with type 2 diabetes mellitus is scarce. Aim To ascertain the effect of five chronic diseases (joint disorder, respiratory disease, anaemia, malignancy, depression) and three chronically used drugs (non-steroid antiinflammatory drugs [NSAIDs], corticosteroids, antidepressants) on treatment for hypoglycaemia in patients with type 2 diabetes. Design and setting Retrospective cohort study in a variety of practices across Flanders, Belgium. Method A retrospective cohort study was conducted, based on data from Intego, a general practice-based continuous morbidity registry. Multiple logistic regression analysis was used to predict the change in glycosylated haemoglobin (HbA1c) levels related to comorbidity, comedication, and a combination of both in 3416 patients with type 2 diabetes. Adjustments were made for age, sex, and diabetestreatment group (diet, oral antidiabetic drugs, combination treatment, insulin). Results Concomitant joint and respiratory disorders, as well as the chronic use of NSAIDs and corticosteroids, either separately or in combination, were significantly associated with the worsening of HbA1c levels. Anaemia, depression, malignancy, and antidepressants had no statistically significant influence on the efficacy of treatment for hypoglycaemia. Conclusion The presence of some comorbid diseases or drug use can impede the efficacy of treatment for type 2 diabetes. This finding supports the need to develop treatment recommendations, taking into account the presence of both chronic comorbidity and comedication. Further research must be undertaken to ascertain the effect other combinations of chronic diseases have on the efficacy of treatment of this and other diseases.
URI: http://hdl.handle.net/1942/15966
DOI: 10.3399/bjgp13X665233
ISI #: 000325522800005
ISSN: 0960-1643
Category: A1
Type: Journal Contribution
Validation: ecoom, 2014
Appears in Collections: Research publications

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