Controlling diabetes

Keeping blood sugar levels in check is an important goal for people with diabetes. In fact, it is a crucial step toward reducing the likelihood of developing diabetes-related complications.

Health professionals have been concerned that so-called 'comorbid conditions'--having other long-term medical conditions in addition to diabetes--can make tight control of blood sugar levels particularly difficult. Researchers from Emory University put this concept to the test, and their results were recently published in the Archives of Internal Medicine.

A closer look at the problem

The researchers studied 654 mostly African American patients coming for a first visit to a diabetes clinic in Georgia, a state in the southern part of the United States. On average, the patients had been living with type 2 diabetes for five years. Eighty percent of them were taking some form of medication for their diabetes.

To identify the presence and severity of other chronic medical conditions in this group, the researchers used a system known as the Chronic Disease Score (CDS), which is based on an individual's prescription medication usage, as well as their age and gender. The researchers also used the results of a blood test called the hemoglobin A1C (HbA1C), a well-accepted measure of blood sugar control. The HbA1C level was obtained when each patient entered the clinic; additionally, the researchers obtained HbA1C values six months later for 169 of the patients.

Researchers found that hypertension, (high blood pressure) was the most likely condition to occur along with diabetes in this group, with over half of the patients being treated for both conditions. When the researchers sorted the patients into five groups based on their CDS, they found that the CDS tended to rise with age, indicating that older patients were more likely to have other medical problems in addition to their diabetes. However, hemoglobin A1C results tended to be lower in older subjects, an indication that as the patients aged, they were better able to control their diabetes.

Multiple diseases don't mean uncontrolled diabetes

After the researchers accounted for age, they found that there was no connection between CDS and hemoglobin A1C. Thus, the presence of other chronic diseases did not appear to affect patients' ability to control their diabetes. Results were similar in those patients for whom follow-up hemoglobin A1C tests were available.

The researchers note that this relatively obese, African American study population may have a chronic disease pattern that is different from the general population. They also note that the CDS method has some limitations. For example, it does not take into account any conditions for which patients are not taking prescription medication.

Nevertheless, this study indicates that people with diabetes in addition to other medical conditions can still keep their diabetes in control. And controlling blood sugar levels should be a primary goal for this group, as well as for other individuals who do not have additional medical problems.