{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["7(6)"],"submitter":["Voorham J"],"pubmed_abstract":["<h4>Background</h4>Comorbidity is often mentioned as interfering with \"optimal\" treatment decisions in diabetes care. It is suggested that diabetes-related comorbidity will increase adequate treatment, whereas diabetes-unrelated comorbidity may decrease this process of care. We hypothesized that these effects differ according to expected priority of the conditions.<h4>Methods</h4>We evaluated the relationship between comorbidity and treatment intensification in a study of 11,248 type 2 diabetes patients using the GIANTT (Groningen Initiative to Analyse type 2 diabetes Treatment) database. We formed a cohort of patients with a systolic blood pressure ≥ 140 mmHg (6,820 hypertensive diabetics), and a cohort of patients with an HbA1c ≥ 7% (3,589 hyperglycemic diabetics) in 2007. We differentiated comorbidity by diabetes-related or unrelated conditions and by priority. High priority conditions include conditions that are life-interfering, incident or requiring new medication treatment. We performed Cox regression analyses to assess association with treatment intensification, defined as dose increase, start, or addition of drugs.<h4>Results</h4>In both the hypertensive and hyperglycemic cohort, only patients with incident diabetes-related comorbidity had a higher chance of treatment intensification (HR 4.48, 2.33-8.62 (p<0.001) for hypertensives; HR 2.37, 1.09-5.17 (p = 0.030) for hyperglycemics). Intensification of hypertension treatment was less likely when a new glucose-regulating drug was prescribed (HR 0.24, 0.06-0.97 (p = 0.046)). None of the prevalent or unrelated comorbidity was significantly associated with treatment intensification.<h4>Conclusions</h4>Diabetes-related comorbidity induced better risk factor treatment only for incident cases, implying that appropriate care is provided more often when complications occur. Diabetes-unrelated comorbidity did not affect hypertension or hyperglycemia management, even when it was incident or life-interfering. Thus, the observed \"undertreatment\" in diabetes care cannot be explained by constraints caused by such comorbidity."],"journal":["PloS one"],"pagination":["e38707"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC3367971"],"repository":["biostudies-literature"],"pubmed_title":["Differential effects of comorbidity on antihypertensive and glucose-regulating treatment in diabetes mellitus--a cohort study."],"pmcid":["PMC3367971"],"pubmed_authors":["Stolk RP","Voorham J","Wolffenbuttel BH","Haaijer-Ruskamp FM","de Zeeuw D","Denig P"],"additional_accession":[]},"is_claimable":false,"name":"Differential effects of comorbidity on antihypertensive and glucose-regulating treatment in diabetes mellitus--a cohort study.","description":"<h4>Background</h4>Comorbidity is often mentioned as interfering with \"optimal\" treatment decisions in diabetes care. It is suggested that diabetes-related comorbidity will increase adequate treatment, whereas diabetes-unrelated comorbidity may decrease this process of care. We hypothesized that these effects differ according to expected priority of the conditions.<h4>Methods</h4>We evaluated the relationship between comorbidity and treatment intensification in a study of 11,248 type 2 diabetes patients using the GIANTT (Groningen Initiative to Analyse type 2 diabetes Treatment) database. We formed a cohort of patients with a systolic blood pressure ≥ 140 mmHg (6,820 hypertensive diabetics), and a cohort of patients with an HbA1c ≥ 7% (3,589 hyperglycemic diabetics) in 2007. We differentiated comorbidity by diabetes-related or unrelated conditions and by priority. High priority conditions include conditions that are life-interfering, incident or requiring new medication treatment. We performed Cox regression analyses to assess association with treatment intensification, defined as dose increase, start, or addition of drugs.<h4>Results</h4>In both the hypertensive and hyperglycemic cohort, only patients with incident diabetes-related comorbidity had a higher chance of treatment intensification (HR 4.48, 2.33-8.62 (p<0.001) for hypertensives; HR 2.37, 1.09-5.17 (p = 0.030) for hyperglycemics). Intensification of hypertension treatment was less likely when a new glucose-regulating drug was prescribed (HR 0.24, 0.06-0.97 (p = 0.046)). None of the prevalent or unrelated comorbidity was significantly associated with treatment intensification.<h4>Conclusions</h4>Diabetes-related comorbidity induced better risk factor treatment only for incident cases, implying that appropriate care is provided more often when complications occur. Diabetes-unrelated comorbidity did not affect hypertension or hyperglycemia management, even when it was incident or life-interfering. Thus, the observed \"undertreatment\" in diabetes care cannot be explained by constraints caused by such comorbidity.","dates":{"release":"2012-01-01T00:00:00Z","publication":"2012","modification":"2022-02-09T11:36:28.294Z","creation":"2019-03-26T23:13:22Z"},"accession":"S-EPMC3367971","cross_references":{"pubmed":["22679516"],"doi":["10.1371/journal.pone.0038707"]}}