RT Journal
A1 El-Kebbi IM, Ziemer DC, Cook CB, Miller CD, Gallina DL, Phillips LS
T1 COmorbidity and glycemic control in patients with type 2 diabetes
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2001
FD May 28
VO 161
IS 10
SP 1295
OP 1300
DO 10.1001/archinte.161.10.1295
UL http://dx.doi.org/10.1001/archinte.161.10.1295
AB Background 
    It is commonly believed that good glycemic control is hard to achieve in patients with diabetes mellitus and concurrent chronic illnesses.Objective 
    To determine the impact of comorbidity on glycemic control at presentation and subsequent follow-up in patients with type 2 diabetes.Methods 
    We studied 654 consecutive patients who presented to a diabetes clinic in 1997. Comorbidity was rated using the Chronic Disease Score (CDS) index, which is a validated, weighted score that takes into account the patient's age, sex, and classes of medications. Univariate and multivariate linear regressions were used to determine the contribution of age, body mass index (calculated as weight in kilograms divided by the square of height in meters), diabetes duration, type of therapy, and CDS to initial hemoglobin A1c (HbA1c) level. A similar analysis was performed for the 169 patients with follow-up HbA1c levels 6 months after presentation.Results 
    Patients were 90% African American, and 66% female, with average age of 53 years. Average diabetes duration was 5 years; body mass index, 33; HbA1c level, 8.8%; and CDS, 1121 (range, 232-7953). At presentation, patients with higher CDSs tended to be older and to have a lower HbA1c level, but multivariate linear regression showed that receiving pharmacological therapy, younger age, and having a lower C-peptide level were the only significant contributors to HbA1c level. In the 169 follow-up patients, presenting characteristics were not significantly different from those of the full cohort: average initial HbA1c level was 8.8%; CDS, 1073. Their HbA1c level at 6 months averaged 7.5% and the CDS had no significant impact on their follow-up HbA1c level.Conclusion 
    Comorbidity does not appear to limit achievement of good glycemic control in patients with type 2 diabetes.