Faculty Collaboration Database

Geographic and racial/ethnic variations in patterns of multimorbidity burden in patients with type 2 diabetes. J Gen Intern Med 2015 Jan;30(1):25-32

Date

08/17/2014

Pubmed ID

25127728

Pubmed Central ID

PMC4284278

DOI

10.1007/s11606-014-2990-y

Scopus ID

2-s2.0-84943423650 (requires institutional sign-in at Scopus site)   28 Citations

Abstract

BACKGROUND: Multimorbidity presents a significant public health challenge, but regional, rural/urban, and racial/ethnic differences in patterns of multimorbidity in diabetes are poorly understood.

OBJECTIVE: To describe patterns of multimorbidity in medical and mental health by regional, rural/urban, and racial/ethnic variation in patients with type 2 diabetes mellitus.

DESIGN: Retrospective cohort study from 2002 through 2006 PARTICIPANTS: A national cohort of 892,223 veterans with diabetes

MAIN MEASURES: Multimorbidity was the main outcome defined as: the measure of multimorbidity and two categorical outcomes, with pattern of medical and mental health comorbidities combined and separately.

KEY RESULTS: Among patients, 52% had 2+ comorbidities, 33% had a single comorbidity, and 14% had no comorbidity; 13.9% had both medical and mental health comorbidities, 70.3% had medical only, and 1.5% had mental health only. The odds of having 3+ comorbidities were nearly fourfold greater in patients 75 years and older relative to patients younger than 50 years (OR=3.95 [95% CI: 3.84, 4.06]). Compared to non-Hispanic whites, the odds of 3+ comorbidities among non-Hispanic blacks were 1.67 times greater (95% CI: 1.63, 1.71). Hispanics were more likely to have a mental health comorbidity alone (OR=1.20 [95% CI: 1.13, 1.28]) than non-Hispanic whites. For patients living in rural areas, the odds were higher of having 3+ comorbidities (OR=1.21 [95% CI: 1.19, 1.23]) and of having both medical and mental health comorbidities (OR=1.15 [95% CI: 1.13, 1.17]) compared to urban dwellers.

CONCLUSIONS: Among individuals with diabetes, traditionally disadvantaged groups, including non-Hispanic blacks and rural patients, appear to bear the greatest burden and risk of multimorbidity. Significantly greater odds with increasing number of comorbidities were seen by race/ethnicity, rural residence, and geographic region.

Author List

Lynch CP, Gebregziabher M, Axon RN, Hunt KE, Payne E, Egede LE

Author

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Comorbidity
Diabetes Mellitus, Type 2
Female
Humans
Male
Middle Aged
Retrospective Studies
Rural Health
United States
Urban Health
Veterans