Keywords
Diabetes
Dyslipidemia
Arterial hypertension
Dyslipidemia
Arterial hypertension
How to Cite
Arteaga Zambrano, A., Solorzano Veliz, S., & Castro Jalca, J. (2024). Comorbidities associated with diabetes mellitus in the adult population. Global Knowledge, 9(S1), 234-244. https://doi.org/10.70165/cglobal.v9iS1.544
Abstract
Diabetes mellitus (DM) is a chronic disease with a high prevalence worldwide, frequently associated with various comorbidities that aggravate the health status of patients. The general objective of this review article was to demonstrate the comorbidities associated with diabetes mellitus in the adult population. The methodology used was a descriptive systematic documentary review. The results show a significant variability in the prevalence of DM, with rates ranging from 8.5% (n=12,811) in Argentina to 67% (n=1,911) in Saudi Arabia. The most common comorbidities associated with DM include hypertension (HT), dyslipidemia, and obesity, with prevalences of HT reaching up to 70%. These comorbidities not only complicate the management of DM, but also increase the risk of developing cardiovascular and renal disease. Among the diagnostic methods, I highlight the use of fasting plasma glucose testing. In conclusion, the high prevalence of DM and its associated comorbidities highlight the need for a comprehensive approach to diabetes management. This approach should include strategies for prevention and treatment of comorbidities to improve the quality of life and health outcomes of diabetic patients. The findings underscore the importance of implementing public health policies and intervention programs that address both the prevention of diabetes and the management of its comorbidities in the adult population.
References
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Bansode, B., & Prasad, J. B. (2022). Burden of comorbidities among diabetic patients in Latur, India. Clinical Epidemiology and Global Health, 13, 100957. https://doi.org/https://doi.org/10.1016/j.cegh.2021.100957
Barrera-Guarderas, F., Flor, A., Coba-Loor, S., & Chacón-Andrade, K. (2023). Diabetic retinopathy: long-term follow-up of Ecuadorian patients with type 2 diabetes in primary care. International Journal of Diabetes in Developing Countries, 43(3), 441–447. https://doi.org/10.1007/s13410-022-01109-9
Bernabe-Ortiz, A., Borjas-Cavero, D. B., Páucar-Alfaro, J. D., & Carrillo-Larco, R. M. (2022). Multimorbidity Patterns among People with Type 2 Diabetes Mellitus: Findings from Lima, Peru. International Journal of Environmental Research and Public Health, 19(15). https://doi.org/10.3390/ijerph19159333
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García-Rivera, E., Ruiz-Serrano, K., Miranda, E., Mejía, L., Pinzón, A., Marqués-Goyco, C., Quijada, J., Monsanto, H., & Orengo, J. (2024). Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus living in Puerto Rico. Journal of Multimorbidity and Comorbidity, 14(6), 1–12. https://doi.org/10.1177/26335565231224570
Gazzaz, Z. J., Iftikhar, R., Jameel, T., Baig, M., & Murad, M. A. (2020). Association of dyslipidemia and comorbidities with risk factors among diabetic patients: A retrospective analysis. Diabetes, Metabolic Syndrome and Obesity, 13, 935–941. https://doi.org/10.2147/DMSO.S235546
Gomezcoello Vásquez, V., Caza, M., & Jácome Sánchez, E. (2021). Prevalencia de diabetes mellitus y sus complicaciones en adultos mayores en un centro de referencia. Revista Medica Vozandes, 31(2), 49–55. https://doi.org/10.48018/rmv.v31.i2.7
Guerrero-Fernández de Alba, I., Orlando, V., Monetti, V. M., Mucherino, S., Gimeno-Miguel, A., Vaccaro, O., Forjaz, M. J., Poblador Plou, B., Prados-Torres, A., Riccardi, G., & Menditto, E. (2020). Comorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients. Frontiers in Pharmacology, 11. https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.586187
Instituto Nacional de estadistica y censos (INEC). (2021). Defunciones Generales. https://www.ecuadorencifras.gob.ec/defunciones-generales/
Ismail, R., Ismail, N. H., Mohd Tamil, A., Ja’afar, M. H., Md Isa, Z., Mat Nasir, N., Ariffin, F., Ramli, A. S., Zainol Abidin, N., Ab Razak, N. H., & Yusof, K. H. (2023). Prevalence and factors associated with prediabetes and diabetes mellitus among adults: Baseline findings of PURE Malaysia cohort study. Clinical Epidemiology and Global Health, 21. https://doi.org/10.1016/j.cegh.2023.101279
Kristanti, D., Rahajeng, E., Sulistiowati, E., Kusumawardani, N., & Dany, F. (2021). Determinants of diabetes comorbidities in Indonesia: a cohort study of non-communicable disease risk factor. Universa Medicina, 40(1), 3–13. https://doi.org/10.18051/univmed.2021.v40.3-13
Mata Cases, M., Franch Nadal, J., Real, J., Cedenilla, M., & Mauricio, D. (2019). Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study. BMJ Open, 9(10), e031281. https://bmjopen.bmj.com/content/9/10/e031281
Ministerio de Salud Pública del Ecuador. (2018). Ministerio de Salud: prevención y autocuidado son claves para controlar la diabetes. https://www.salud.gob.ec/ministerio-de-salud-prevencion-y-autocuidado-son-claves-para-controlar-la-diabetes/
Negussie, Y. M., Getahun, M. S., & Bekele, N. T. (2023). Factors associated with diabetes concordant comorbidities among adult diabetic patients in Central Ethiopia: a cross-sectional study. Frontiers in Clinical Diabetes and Healthcare, 4. https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2023.1307463
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Nuhoglu, İ., Deger, O., Topbaş, M., & Erem, C. (2022). The prevalence of diabetes and associated risk factors among adult population in a Turkish population (Trabzon city). Primary Care Diabetes, 16(4), 549–554. https://doi.org/https://doi.org/10.1016/j.pcd.2022.05.010
Ohsugi, M., Eiki, J., Iglay, K., Tetsuka, J., Tokita, S., & Ueki, K. (2021). Comorbidities and complications in Japanese patients with type 2 diabetes mellitus: Retrospective analyses of J-DREAMS, an advanced electronic medical records database. Diabetes Research and Clinical Practice, 178(12), 7. https://doi.org/10.1016/j.diabres.2021.108845
Organizacion Mundial de la Salud(OMS). (2021). Diabetes-Panorama General. https://www.who.int/es/news-room/fact-sheets/detail/diabetes
Pauli, A., de Mestral, C., & Marques-Vidal, P. (2024). Trends in diabetes prevalence, awareness, treatment, and control in French-speaking Switzerland. Scientific Reports, 14(1), 4839. https://doi.org/10.1038/s41598-024-54856-6
Russo, M. P., Grande-Ratti, M. F., Burgos, M. A., Molaro, A. A., & Bonella, M. B. (2023). Prevalence of diabetes, epidemiological characteristics and vascular complications. Archivos de Cardiologia de Mexico, 93(1), 30–36. https://doi.org/10.24875/ACM.21000410
Seifu, Y., Tsegaw, D., Haji, Y., & Ejeso, A. (2020). Prevalence and associated factors of diabetes mellitus among adult population in Hawassa Zuria Woreda, Sidama Region, Ethiopia. Diabetes, Metabolic Syndrome and Obesity, 13, 4571–4579. https://doi.org/10.2147/DMSO.S275230
Severson, K. J., Patel, M. H., Brumfiel, C. M., Breen, I., Butterfield, R. J., Nelson, S. A., Sekulic, A., Pittelkow, M. R., & Mangold, A. R. (2022). Comorbidities and diabetic complications in patients with necrobiosis lipoidica. Journal of the American Academy of Dermatology, 86(4), 891–894. https://doi.org/10.1016/j.jaad.2021.03.026
Shi, M., Zhang, X., & Wang, H. (2022). The Prevalence of Diabetes, Prediabetes and Associated Risk Factors in Hangzhou, Zhejiang Province: A Community-Based Cross-Sectional Study. Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy, 15, 713–721. https://doi.org/10.2147/DMSO.S351218
Shuvo, S. Das, Hossen, M. T., Riazuddin, M., Hossain, M. S., Mazumdar, S., Parvin, R., & Elahi, M. T. (2023). Prevalence of comorbidities and its associated factors among type-2 diabetes patients: a hospital-based study in Jashore District, Bangladesh. BMJ Open, 13(9), e076261. http://dx.doi.org/10.1136/bmjopen-2023-076261corr1
Talukder, A., & Hossain, M. Z. (2020). Prevalence of Diabetes Mellitus and Its Associated Factors in Bangladesh: Application of Two-level Logistic Regression Model. Scientific Reports, 10(1), 10237. https://doi.org/10.1038/s41598-020-66084-9
Tentolouris, A., Eleftheriadou, I., Athanasakis, K., Kyriopoulos, J., Tsilimigras, D. I., Grigoropoulou, P., Doupis, J., & Tentolouris, N. (2020). Prevalence of diabetes mellitus as well as cardiac and other main comorbidities in a representative sample of the adult Greek population in comparison with the general population. Hellenic Journal of Cardiology, 61(1), 15–22. https://doi.org/https://www.doi.org/10.1016/J.DSX.2019.01.030
Ukah, E. D., Oguntade, E. S., & Oladimeji, D. M. (2023). Factors associated with type 2 diabetes mellitus comorbidity among adult patients: a retrospective clinical audit of a medical centre in Abuja, Nigeria. Journal of Global Health Reports, 7, e2023046. https://doi.org/10.29392/001c.88106
Villacorta Santamato, J., Hilario Huapaya, N., Inolopú Cucche, J., Terrel Gutierrez, L., Labán Hijar, R., Aguila, J. Del, Ugarte Gil, C., & Hurtado Roca, Y. (2020). Factores asociados a complicaciones crónicas de diabetes mellitus tipo 2 en pacientes de un hospital general del Seguro Social de Salud del Perú. Anales de La Facultad de Medicina, 81(3), 308–315. https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/17260
Zerihun, E., Abera, F., Kune, G., Girma, F., Tesgera, M., & Robi, M. (2024). Undiagnosed status and associated factors of diabetes mellitus among adults living in eastern Ethiopia: Unmasking a silent killer of prevalence of diabetes mellitus. Clinical Epidemiology and Global Health, 25, 101483. https://cegh.net/article/S2213-3984(23)00270-1/pdf
Akın, S., & Bölük, C. (2020). Prevalence of comorbidities in patients with type–2 diabetes mellitus. Primary Care Diabetes, 14(5), 431–434. https://doi.org/10.1016/j.pcd.2019.12.006
Antar, S. A., Ashour, N. A., Sharaky, M., Khattab, M., Ashour, N. A., Zaid, R. T., Roh, E. J., Elkamhawy, A., & Al-Karmalawy, A. A. (2023). Diabetes mellitus: Classification, mediators, and complications; A gate to identify potential targets for the development of new effective treatments. Biomedicine and Pharmacotherapy, 168, 115734. https://doi.org/10.1016/J.BIOPHA.2023.115734
Argano, C., Natoli, G., Mularo, S., Nobili, A., Monaco, M. L., Mannucci, P. M., Perticone, F., Pietrangelo, A., & Corrao, S. (2022). Impact of Diabetes Mellitus and Its Comorbidities on Elderly Patients Hospitalized in Internal Medicine Wards: Data from the RePoSi Registry. Healthcare, 10(1). https://doi.org/10.3390/healthcare10010086
Bai, A., Tao, J., Tao, L., & Liu, J. (2021). Prevalence and risk factors of diabetes among adults aged 45 years or older in China: A national cross-sectional study. Endocrinology, Diabetes & Metabolism, 4(3), e00265. https://doi.org/10.1002/edm2.265
Bansode, B., & Prasad, J. B. (2022). Burden of comorbidities among diabetic patients in Latur, India. Clinical Epidemiology and Global Health, 13, 100957. https://doi.org/https://doi.org/10.1016/j.cegh.2021.100957
Barrera-Guarderas, F., Flor, A., Coba-Loor, S., & Chacón-Andrade, K. (2023). Diabetic retinopathy: long-term follow-up of Ecuadorian patients with type 2 diabetes in primary care. International Journal of Diabetes in Developing Countries, 43(3), 441–447. https://doi.org/10.1007/s13410-022-01109-9
Bernabe-Ortiz, A., Borjas-Cavero, D. B., Páucar-Alfaro, J. D., & Carrillo-Larco, R. M. (2022). Multimorbidity Patterns among People with Type 2 Diabetes Mellitus: Findings from Lima, Peru. International Journal of Environmental Research and Public Health, 19(15). https://doi.org/10.3390/ijerph19159333
Brož, J., Malinovská, J., Nunes, M. A., Kučera, K., Rožeková, K., Žejglicová, K., Urbanová, J., Jenšovský, M., Brabec, M., & Lustigová, M. (2020). Prevalence of diabetes and prediabetes and its risk factors in adults aged 25–64 in the Czech Republic: A cross-sectional study. Diabetes Research and Clinical Practice, 170, 108470. https://doi.org/https://doi.org/10.1016/j.diabres.2020.108470
Dai, J., Niu, X., Bullock, A., Manson, S. M., O’Connell, J., & Jiang, L. (2023). Prevalence of Diagnosed Type 1 and Type 2 Diabetes Among American Indian and Alaska Native Peoples in 2012–2013. Diabetes Care, 47(1), e1–e3. https://doi.org/10.2337/dc23-0930
Das, U., & Kar, N. (2023). Prevalence and risk factor of diabetes among the elderly people in West Bengal: evidence-based LASI 1st wave. BMC Endocrine Disorders, 23(1), 170. https://doi.org/10.1186/s12902-023-01421-3
Ejeta, A., Abdosh, T., Hawulte, B., Lamessa, A., Belete Fite, M., & Fekadu, G. (2021). Diabetes Concordant Comorbidities and Associated Factors Among Adult Diabetic Out-Patients at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: a Cross-Sectional Study. Diabetes, Metabolic Syndrome and Obesity, 14(null), 2281–2289. https://doi.org/10.2147/DMSO.S308553
Fazekas-Pongor, V., Domján, B. A., Major, D., Péterfi, A., Horváth, V. J., Mészáros, S., Vokó, Z., Vásárhelyi, B., Szabó, A. J., Burián, K., Merkely, B., & Tabák, A. G. (2024). Prevalence and determinants of diagnosed and undiagnosed diabetes in Hungary based on the nationally representative cross-sectional H-UNCOVER study. Diabetes Research and Clinical Practice, 0(0), 111834. https://doi.org/10.1016/J.DIABRES.2024.111834
García-Rivera, E., Ruiz-Serrano, K., Miranda, E., Mejía, L., Pinzón, A., Marqués-Goyco, C., Quijada, J., Monsanto, H., & Orengo, J. (2024). Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus living in Puerto Rico. Journal of Multimorbidity and Comorbidity, 14(6), 1–12. https://doi.org/10.1177/26335565231224570
Gazzaz, Z. J., Iftikhar, R., Jameel, T., Baig, M., & Murad, M. A. (2020). Association of dyslipidemia and comorbidities with risk factors among diabetic patients: A retrospective analysis. Diabetes, Metabolic Syndrome and Obesity, 13, 935–941. https://doi.org/10.2147/DMSO.S235546
Gomezcoello Vásquez, V., Caza, M., & Jácome Sánchez, E. (2021). Prevalencia de diabetes mellitus y sus complicaciones en adultos mayores en un centro de referencia. Revista Medica Vozandes, 31(2), 49–55. https://doi.org/10.48018/rmv.v31.i2.7
Guerrero-Fernández de Alba, I., Orlando, V., Monetti, V. M., Mucherino, S., Gimeno-Miguel, A., Vaccaro, O., Forjaz, M. J., Poblador Plou, B., Prados-Torres, A., Riccardi, G., & Menditto, E. (2020). Comorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients. Frontiers in Pharmacology, 11. https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.586187
Instituto Nacional de estadistica y censos (INEC). (2021). Defunciones Generales. https://www.ecuadorencifras.gob.ec/defunciones-generales/
Ismail, R., Ismail, N. H., Mohd Tamil, A., Ja’afar, M. H., Md Isa, Z., Mat Nasir, N., Ariffin, F., Ramli, A. S., Zainol Abidin, N., Ab Razak, N. H., & Yusof, K. H. (2023). Prevalence and factors associated with prediabetes and diabetes mellitus among adults: Baseline findings of PURE Malaysia cohort study. Clinical Epidemiology and Global Health, 21. https://doi.org/10.1016/j.cegh.2023.101279
Kristanti, D., Rahajeng, E., Sulistiowati, E., Kusumawardani, N., & Dany, F. (2021). Determinants of diabetes comorbidities in Indonesia: a cohort study of non-communicable disease risk factor. Universa Medicina, 40(1), 3–13. https://doi.org/10.18051/univmed.2021.v40.3-13
Mata Cases, M., Franch Nadal, J., Real, J., Cedenilla, M., & Mauricio, D. (2019). Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study. BMJ Open, 9(10), e031281. https://bmjopen.bmj.com/content/9/10/e031281
Ministerio de Salud Pública del Ecuador. (2018). Ministerio de Salud: prevención y autocuidado son claves para controlar la diabetes. https://www.salud.gob.ec/ministerio-de-salud-prevencion-y-autocuidado-son-claves-para-controlar-la-diabetes/
Negussie, Y. M., Getahun, M. S., & Bekele, N. T. (2023). Factors associated with diabetes concordant comorbidities among adult diabetic patients in Central Ethiopia: a cross-sectional study. Frontiers in Clinical Diabetes and Healthcare, 4. https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2023.1307463
Nowakowska, M., Zghebi, S. S., Ashcroft, D. M., Buchan, I., Chew-Graham, C., Holt, T., Mallen, C., Van Marwijk, H., Peek, N., Perera-Salazar, R., Reeves, D., Rutter, M. K., Weng, S. F., Qureshi, N., Mamas, M. A., & Kontopantelis, E. (2019). The comorbidity burden of type 2 diabetes mellitus: patterns, clusters and predictions from a large English primary care cohort. BMC Medicine, 17(1), 1–10. https://doi.org/10.1186/s12916-019-1373-y
Nuhoglu, İ., Deger, O., Topbaş, M., & Erem, C. (2022). The prevalence of diabetes and associated risk factors among adult population in a Turkish population (Trabzon city). Primary Care Diabetes, 16(4), 549–554. https://doi.org/https://doi.org/10.1016/j.pcd.2022.05.010
Ohsugi, M., Eiki, J., Iglay, K., Tetsuka, J., Tokita, S., & Ueki, K. (2021). Comorbidities and complications in Japanese patients with type 2 diabetes mellitus: Retrospective analyses of J-DREAMS, an advanced electronic medical records database. Diabetes Research and Clinical Practice, 178(12), 7. https://doi.org/10.1016/j.diabres.2021.108845
Organizacion Mundial de la Salud(OMS). (2021). Diabetes-Panorama General. https://www.who.int/es/news-room/fact-sheets/detail/diabetes
Pauli, A., de Mestral, C., & Marques-Vidal, P. (2024). Trends in diabetes prevalence, awareness, treatment, and control in French-speaking Switzerland. Scientific Reports, 14(1), 4839. https://doi.org/10.1038/s41598-024-54856-6
Russo, M. P., Grande-Ratti, M. F., Burgos, M. A., Molaro, A. A., & Bonella, M. B. (2023). Prevalence of diabetes, epidemiological characteristics and vascular complications. Archivos de Cardiologia de Mexico, 93(1), 30–36. https://doi.org/10.24875/ACM.21000410
Seifu, Y., Tsegaw, D., Haji, Y., & Ejeso, A. (2020). Prevalence and associated factors of diabetes mellitus among adult population in Hawassa Zuria Woreda, Sidama Region, Ethiopia. Diabetes, Metabolic Syndrome and Obesity, 13, 4571–4579. https://doi.org/10.2147/DMSO.S275230
Severson, K. J., Patel, M. H., Brumfiel, C. M., Breen, I., Butterfield, R. J., Nelson, S. A., Sekulic, A., Pittelkow, M. R., & Mangold, A. R. (2022). Comorbidities and diabetic complications in patients with necrobiosis lipoidica. Journal of the American Academy of Dermatology, 86(4), 891–894. https://doi.org/10.1016/j.jaad.2021.03.026
Shi, M., Zhang, X., & Wang, H. (2022). The Prevalence of Diabetes, Prediabetes and Associated Risk Factors in Hangzhou, Zhejiang Province: A Community-Based Cross-Sectional Study. Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy, 15, 713–721. https://doi.org/10.2147/DMSO.S351218
Shuvo, S. Das, Hossen, M. T., Riazuddin, M., Hossain, M. S., Mazumdar, S., Parvin, R., & Elahi, M. T. (2023). Prevalence of comorbidities and its associated factors among type-2 diabetes patients: a hospital-based study in Jashore District, Bangladesh. BMJ Open, 13(9), e076261. http://dx.doi.org/10.1136/bmjopen-2023-076261corr1
Talukder, A., & Hossain, M. Z. (2020). Prevalence of Diabetes Mellitus and Its Associated Factors in Bangladesh: Application of Two-level Logistic Regression Model. Scientific Reports, 10(1), 10237. https://doi.org/10.1038/s41598-020-66084-9
Tentolouris, A., Eleftheriadou, I., Athanasakis, K., Kyriopoulos, J., Tsilimigras, D. I., Grigoropoulou, P., Doupis, J., & Tentolouris, N. (2020). Prevalence of diabetes mellitus as well as cardiac and other main comorbidities in a representative sample of the adult Greek population in comparison with the general population. Hellenic Journal of Cardiology, 61(1), 15–22. https://doi.org/https://www.doi.org/10.1016/J.DSX.2019.01.030
Ukah, E. D., Oguntade, E. S., & Oladimeji, D. M. (2023). Factors associated with type 2 diabetes mellitus comorbidity among adult patients: a retrospective clinical audit of a medical centre in Abuja, Nigeria. Journal of Global Health Reports, 7, e2023046. https://doi.org/10.29392/001c.88106
Villacorta Santamato, J., Hilario Huapaya, N., Inolopú Cucche, J., Terrel Gutierrez, L., Labán Hijar, R., Aguila, J. Del, Ugarte Gil, C., & Hurtado Roca, Y. (2020). Factores asociados a complicaciones crónicas de diabetes mellitus tipo 2 en pacientes de un hospital general del Seguro Social de Salud del Perú. Anales de La Facultad de Medicina, 81(3), 308–315. https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/17260
Zerihun, E., Abera, F., Kune, G., Girma, F., Tesgera, M., & Robi, M. (2024). Undiagnosed status and associated factors of diabetes mellitus among adults living in eastern Ethiopia: Unmasking a silent killer of prevalence of diabetes mellitus. Clinical Epidemiology and Global Health, 25, 101483. https://cegh.net/article/S2213-3984(23)00270-1/pdf
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