Managing Common Diabetes Comorbidities: Going Beyond Standard Care

This Physician’s Weekly feature covering the management of common diabetes comorbidities was completed in cooperation with the experts at the American Diabetes Association. Throughout the medical literature, it has been well documented that patients with type 2 diabetes are at increased risk for developing cardiovascular disorders, including coronary artery disease and stroke. The constellation of symptoms that includes insulin resistance and obesity greatly increases the likelihood of additional comorbidities emerging. “In addition to the commonly appreciated comorbidities of obesity, hypertension, and dyslipidemia,” says Medha N. Munshi, MD, “diabetes is also associated with other diseases or conditions at rates higher than those of people without diabetes.” In keeping with patient-centered approaches to care, physicians should be aware of the wide spectrum of comorbidities their patients face when managing them throughout their disease course. When the risk for these comorbidities is elevated, patients should be treated accordingly. The American Diabetes Association reports that some of the more common comorbidities outside the realm of obesity, hypertension, and dyslipidemia include obstructive sleep apnea (OSA), fatty liver disease, cancer, and fractures (Table 1). “Clinicians should consider these other comorbidities during their care of patients with diabetes to optimize outcomes,” says Dr. Munshi. Obstructive Sleep Apnea OSA is the most common form of sleep-disordered breathing in patients with type 2 diabetes, accounting for over 80% of cases. In people with diabetes, the prevalence of OSA has been documented to be as high as 23% and the prevalence of some form of sleep disordered breathing may be as high as 58%. “Treating sleep apnea can significantly improve quality of life and blood pressure control,” Dr. Munshi...