Categories: Endocrinology

Co-morbidity and Diabetes

To simply say, comorbidity means the presence of more than one disease in an individual. For instance, if an individual is diagnosed to have both diabetes and high blood pressure, they are said to have co-morbid (which means “along with”) diabetes and hypertension disorders.

If you have diabetes, your doctor will examine you for signs and symptoms of co-morbid conditions that can affect your health and have an impact on your treatment.

Common co-morbidities in Diabetes:

  • Hypertension:

High BP or hypertension, is a condition where your BP exceeds over 140 mmHg systolic and 90 mmHg diastolic. More than 50% of individuals with diabetes are likely to have hypertension. This isn’t unexpected, given the two conditions share huge numbers of similar risk factors, including a sedentary lifestyle and being overweight. It likewise is important that individuals who have hypertension can develop insulin resistance, which can be a precursor to Type 2 diabetes. The consolidated effect of diabetes and hypertension can expand the danger of cardiovascular disease, kidney disease, and other health issues. There are three ways by which high glucose levels in the blood can develop blood pressure:

  • The blood vessels lose their capacity to stretch
  • The liquid in the body increases, particularly if diabetes is affecting the kidneys
  • Insulin resistance

Hypertension can prompt numerous complications of diabetes, including diabetic eye disease and kidney disease, or worsen them. Diabetes harms arteries and makes them vulnerable for solidifying, called Atherosclerosis. That can cause hypertension, which if not treated, can lead to difficulties including blood vessel damage, heart attack, and kidney failure. Controlling glucose levels and BP can help forestall complications.

  • Obesity:

Obesity is characterized as irregular or excessive accumulation of body fat that has a negative effect on health. Obesity increases the risk of diabetes and cardiovascular diseases.

In an obese person with diabetes, the cells in the body become more resistant to the actions of the insulin. People with Type 2 diabetes, who exercise, reduce the insulin-resistance because the exercising muscles utilize the extra sugar found in the blood. Even a 5% reduction in body weight with the help of diet and exercise can have lower insulin resistance and subsequently improve blood glucose levels. People hauling more weight around their waist (apple-shaped) are bound to experience the ill effects of obesity-related conditions than somebody who carries more weight in their hips and thighs (pear-shaped).

People with excess weight, especially obese and extremely obese, are bound to develop Type 2 diabetes as a related condition of their abundance weight. Obesity increases your danger of developing heart disease, type 2 diabetes, certain types of cancer, sleep apnea, osteoarthritis, and more.

  • Dyslipidemia:

This condition is described by an unusual degree of lipids (fats) in the blood. This generally incorporates increased degrees of Low-density Lipoproteins (LDL) cholesterol particles, the purported “bad” cholesterol, and raised degrees of triglycerides. Dyslipidemia may likewise include anomalous low degrees of the High-density Lipoproteins (HDL) that function to remove LDL from the blood. Dyslipidemia might be hereditary and additionally worsened with lifestyle factors. It shares a considerable amount of similar risk factors like diabetes and is a common comorbidity. When a diabetic patient has dyslipidemia, the patient is at risk of developing heart attacks, stroke, hypertension, kidney damage, and eye damage.

  • Non-alcoholic fatty liver disease (NAFLD):

Set apart by raised liver enzymes and growth of the organ because of a collection of fat, the danger of Non-alcoholic Fatty Liver Disease (NAFLD) increases with obesity and visceral fat deposition and can both cause diabetes or co-exist with diabetes. NAFLD is a genuine concern: If not treated, it can lead to scarring of the liver, an expanded danger of liver cancer or liver failure. A large number of lifestyle measures that assist with overseeing Type 2 diabetes can likewise assist with turning around the Non-alcoholic Fatty Liver Disease, including following a sound eating routine, increasing physical activity, and weight loss. The major complication of NAFLD (Non-alcoholic Fatty Liver Disease) and NASH (Non-alcoholic Steatohepatitis) is Cirrhosis, which is late-stage scarring in the liver. Cirrhosis happens in response to liver injury like inflammation. As the liver attempts to end inflammation, it produces territories of Scarring (Fibrosis). With continued irritation, fibrosis spreads to take up increasingly more liver tissue.

If not stopped, cirrhosis can prompt complications like:

  1. Fluid accumulation in the abdomen (Ascites)
  2. Expanding of veins in your food pipe (Esophageal varices), which can rupture result in blood in vomitus
  3. Disarray, drowsiness and slurred speech (Hepatic encephalopathy)
  4. End-stage liver failure, which implies the liver has stopped working
  • Obstructive sleep apnea:

Sleep apnea is a chronic breathing problem in which an individual stops breathing for brief time frames while sleeping. It might be brought about by abnormalities in the airway, because of excess weight and obesity or related to the brain’s respiratory signals. Obstructive sleep apnea (OSA) changes promote insulin resistance. Weight is a key arbitrator of the impact of OSA on Type 2 diabetes. Individuals with diabetes-related difficulties had progressively serious OSA and were bound to have hypertension and are emphatically connected with OSA. Excess weight is regularly viewed as the reason for OSA in light of the fact that fat stores around the upper airway obstruct breathing. Obesity has been recognized as a huge hazard factor for OSA just as diabetes.

The complication here comprises of –

  • Trouble concentrating and tired throughout the day
  • Day time sleepiness (Eg: Falling asleep watching television)
  • Cardiovascular problems
  • Accidents

Prevention of Co-morbidities in Diabetes:

In the event that you have diabetes, you can reduce your risk of developing co-morbidities by changing lifestyle factors that put you in danger, such as –

  • Keeping up a healthy weight
  • Say no to smoking
  • Being physically active
  • Controlling your glucose levels
  • Getting adequate sleep
  • Being Mindful of choices

What’s more, it’s vital to get a standard medical check-up and recommended health screenings. These can recognize conditions before their development and may forestall full-blown diseases.

Managing Co-morbidities in Diabetes:

In the event that you have a co-morbid condition, you might be treated by more than one doctor. Your primary doctor as well as an affirmed diabetes educator can assist with planning this schedule. It is significant for every one of your providers to be aware of your medications, lab test results, and treatment plans. Similarly, lifestyle changes that can assist with forestalling co-morbid conditions from developing alongside diabetes can likewise be useful for treating them. It’s never past the point to make lifestyle changes to more readily control your glucose. On the off chance that you need assistance beginning a smart dieting or exercise routine, look for a proficient help from a nutritionist, dietitian, or certified diabetes educator.

Dr. Subramanian Kannan | Consultant Endocrinology | Mazumdar Shaw Medical Center, Bommasandra, Bangalore

Narayana Health

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