title: Multimorbidity in a cohort of patients with type 2 diabetes.
abstract: BACKGROUND
  People with type 2 diabetes frequently have a variety of related and unrelated chronic conditions. These additional conditions have implications for patient education, treatment burden and disease management.
  
  
  OBJECTIVE
  The aim of this study was to examine the nature of multimorbidity, and its impact on GP visits, polypharmacy and glycaemic control as measured by HbA1c, in a cohort of patients with type 2 diabetes attending general practice in Ireland.
  
  
  METHODS
  A cohort of 424 patients with type 2 diabetes enrolled in a cluster randomized controlled trial based in Irish general practice was examined. Patient data included: medical conditions, HbA1c, health service utilization, socio-economic status and number of prescribed medications.
  
  
  RESULTS
  90% of patients had at least one additional chronic condition and a quarter had four or more additional chronic conditions. 66% of patients had hypertension; 25% had heart disease; and 16% had arthritis. General practitioner visits and polypharmacy increased significantly with increasing numbers of chronic conditions. When comparing patient self-report with medical records, patients who reported a higher proportion of their conditions had better glycaemic control with a significantly lower HbA1c score.
  
  
  CONCLUSIONS
  There was a high prevalence of multimorbidity in these patients with type 2 diabetes and the results suggest that glycaemic control is related to patients' awareness of their chronic conditions. The variety of conditions emphasizes the complexity of illness management in this group and the importance of maintaining a generalist and multidisciplinary approach to their clinical care.
authors: Department of Public Health and Primary Care, Trinity College Dublin, Dublin 2, Ireland. teljeuc@tcd.ie
authors: Conor
authors: C
authors: Teljeur
authors: Susan M
authors: SM
authors: Smith
authors: Gillian
authors: G
authors: Paul
authors: Alan
authors: A
authors: Kelly
authors: Tom
authors: T
authors: O'Dowd
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy