Edurne Alonso-Morán1, Juan F Orueta2, Jose Ignacio Fraile Esteban3, José Ma Arteagoitia Axpe4, Ma Luz Marqués González5, Nuria Toro Polanco6, Patxi Ezkurra Loiola7, Sonia Gaztambide8, Roberto Nuño-Solinís9. 1. O+berri (Basque Institute for Healthcare Innovation), Torre del BEC (Bilbao Exhibition Centre), Ronda de Azkue 1, 48902 Barakaldo, Spain. Electronic address: edurne.almo@gmail.com. 2. Osakidetza (Basque Health Service), Astrabudua Health Centre, Mezo 35, 48950 Erandio, Spain. 3. Osakidetza (Basque Health Service), San Miguel Health Centre, Garbileku s/n, 48970 Basauri, Spain. 4. Department of Health, Donostia-San Sebastián 1, 01010 Vitoria-Gasteiz, Spain. 5. Osakidetza (Basque Health Service), Uribe Area, Alango 30, 48992 Getxo, Spain. 6. World Health Organization, Services Organization and Clinical Interventions Unit, Avenue Appia 20, CH-1211 Geneva, Switzerland. 7. Osakidetza (Basque Health Service), Zumaia Health Centre, Basadi 15, 20750 Zumaia, Spain. 8. Endocrinology and Nutrition Department, Osakidetza (Basque Health Service), Cruces University Hospital, Plaza de Cruces s/n, 48903 Barakaldo, Spain; The University of the Basque Country, Leioa, Spain; Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain. 9. O+berri (Basque Institute for Healthcare Innovation), Torre del BEC (Bilbao Exhibition Centre), Ronda de Azkue 1, 48902 Barakaldo, Spain.
Abstract
BACKGROUND: Multimorbidity is a common problem in ageing societies and has a wide range of individual and social consequences. The objective of this study was to compare multimorbidity in a population with type 2 diabetes (T2DM) with that in other chronic patients, and identify disease clusters in patients with T2DM. METHODS: We included all citizens in the Basque Health Service aged ≥ 35 years, and identified the population with chronic conditions (from a list of 51 diseases) and those with T2DM. We performed a descriptive analysis of both populations, including their comorbidities. The average of chronic conditions unadjusted and adjusted by socioeconomic variables was obtained. Further, among patients with T2DM, we performed agglomerative hierarchical clustering to identify clinically relevant subgroups with the same concurrent conditions. RESULTS: In 2011, out of a population of 1,473,937, 15.2% had T2DM and 48% some other type of chronic condition. Overall, 87.6% men and 92% of women with T2DM had multimorbidity, while the figures were respectively 54.2% and 57% in chronic patients without T2DM. Patients with T2DM had a higher risk than the general chronic population of having 21 of the 51 chronic conditions considered. We identified 10 relevant disease clusters in patients with T2DM. CONCLUSIONS: There are notable differences between chronic patients with and without T2DM, the prevalence of multimorbidity being greater among the former. Multimorbidity is a complex phenomenon and more research is required to establish the clinical implications of the disease clusters found, to guide the introduction of integrated care management programmes.
BACKGROUND: Multimorbidity is a common problem in ageing societies and has a wide range of individual and social consequences. The objective of this study was to compare multimorbidity in a population with type 2 diabetes (T2DM) with that in other chronic patients, and identify disease clusters in patients with T2DM. METHODS: We included all citizens in the Basque Health Service aged ≥ 35 years, and identified the population with chronic conditions (from a list of 51 diseases) and those with T2DM. We performed a descriptive analysis of both populations, including their comorbidities. The average of chronic conditions unadjusted and adjusted by socioeconomic variables was obtained. Further, among patients with T2DM, we performed agglomerative hierarchical clustering to identify clinically relevant subgroups with the same concurrent conditions. RESULTS: In 2011, out of a population of 1,473,937, 15.2% had T2DM and 48% some other type of chronic condition. Overall, 87.6% men and 92% of women with T2DM had multimorbidity, while the figures were respectively 54.2% and 57% in chronic patients without T2DM. Patients with T2DM had a higher risk than the general chronic population of having 21 of the 51 chronic conditions considered. We identified 10 relevant disease clusters in patients with T2DM. CONCLUSIONS: There are notable differences between chronic patients with and without T2DM, the prevalence of multimorbidity being greater among the former. Multimorbidity is a complex phenomenon and more research is required to establish the clinical implications of the disease clusters found, to guide the introduction of integrated care management programmes.
Authors: Michael Leutner; Nils Haug; Luise Bellach; Elma Dervic; Alexander Kautzky; Peter Klimek; Alexandra Kautzky-Willer Journal: J Pers Med Date: 2021-04-22
Authors: Inmaculada Guerrero Fernández de Alba; Antonio Gimeno-Miguel; Beatriz Poblador-Plou; Luis Andrés Gimeno-Feliu; Ignatios Ioakeim-Skoufa; Gemma Rojo-Martínez; Maria João Forjaz; Alexandra Prados-Torres Journal: Sci Rep Date: 2020-11-11 Impact factor: 4.379
Authors: Meryem Cicek; James Buckley; Jonathan Pearson-Stuttard; Edward W Gregg Journal: Endocrinol Metab Clin North Am Date: 2021-09 Impact factor: 4.741
Authors: Antonio Bernabe-Ortiz; Diego B Borjas-Cavero; Jimmy D Páucar-Alfaro; Rodrigo M Carrillo-Larco Journal: Int J Environ Res Public Health Date: 2022-07-30 Impact factor: 4.614