704-P: Effects of Comorbidity Burden among Adult Medicaid Beneficiaries with Type 2 Diabetes

Abstract

Diabetes self-management and health outcomes are complicated by comorbid conditions. Obesity, arthritis, pain conditions and others can create barriers to exercise and blood sugar goals. The burden patients experience managing chronic conditions may affect subsequent behaviors and outlook, creating a negative cycle. Understanding the impact of patients’ perceptions of comorbidity burden may inform future patient-centered healthcare services and community supports. We conducted a secondary data analysis using baseline and 3 month follow up survey data from an ongoing social needs intervention trial involving adult Medicaid beneficiaries with Type 2 diabetes. The sample (N=350) was 24-68 years old (M=52, SD=9), mostly female (n = 274; 78%), African American (n = 232; 66%) or White (n = 98; 28%), and had a mean of 7.6 (SD=3.0) of the 21 conditions, including diabetes, assessed at baseline. Each condition was rated by participants for impact on their daily activities (1=not at all; 5=a lot). Sum scores reflect ratings for diabetes burden only (M=2.9, SD=1.6) and all other conditions combined (M=21.0, SD=12.7). Bivariate correlations showed significant (p<.05) positive associations between diabetes burden and three month outcomes: sum social needs (r= .17), stress (r= .11), depression (r= .14), diabetes distress (r= .35), frequency of checking blood sugar (r= .16), but inverse associations with difficulty sleeping (r= -.17) and diabetes self-efficacy (r= -.15). The associations with other comorbidity burden ratings were similar except stronger with depression (r= .33) and receipt of government assistance programs (r= .17). Although people with diabetes have substantial self-management responsibilities, the effect was not different from other comorbidity burden on social needs and psychosocial outcomes, suggesting that similar or holistic interventions to reduce the negative effects of disease burden may be more efficient and effective to implement than disease-focused interventions. Disclosure A.Mcqueen: None. N.Verdecias: None. C.A.Caburnay: None. R.E.Smith: None. D.J.Broussard, jr.: None. D.A.Von nordheim: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK115916-01)