Comorbidity and glycemia control among patients with type 2 diabetes in primary care

Catherine Hudon^1,3, Martin Fortin^1,3, Marie-France Dubois², José Almirall³

¹Department of Family Medicine, ²Department of Community Health Sciences, Sherbrooke University, Sherbrooke, Quebec, Canada; ³Centre de Santé et de Services Sociaux de Chicoutimi, Quebec, Canada

Abstract: Reports on the relationship between comorbidity and glycemia control in diabetic patients are conflicting and the method of measuring comorbidity varies widely among studies. The aim of the present study was to evaluate the relationship between diabetes control and comorbidity, taking into account all comorbidities and their severity, in a primary care setting. We performed a retrospective descriptive study based on chart review of 96 randomly selected type 2 diabetic patients. Comorbidity was measured with the cumulative illness rating scale (CIRS), an exhaustive comorbidity index. Diabetes was considered as controlled if the mean value of two measurements of glycosylated hemoglobin A (HbA_1c) was less than 7%. Taking diabetes control as the dependent variable, its relationship with the CIRS score, age, sex, diabetes duration, and diabetes-related complications was explored. Diabetes control was not significantly related with the CIRS score, age, sex or diabetes severity. Diabetes duration was the only variable significantly related to diabetes control. Our study suggests that comorbidity measured with the CIRS in patients with type 2 diabetes is not a factor that prevents the achievement of a good glycemia control.

Keywords: glycemia control, type 2 diabetes mellitus, comorbidity, primary care