Type 2 diabetes mellitus and multiple chronic diseases

Abstract

Background: Recently, there has been an increase in the number of patients with multiple chronic diseases (MCD), particularly due to obesity and ageing. The role of type 2 diabetes mellitus (T2DM) in the development of MCD, however, is still unclear.
 Aims: This study aimed to determine the incidence of T2DM in the structure of polymorbidity considering sex and age-related characteristics.
 Materials and methods: Patients with MCD (n = 2,254; 769 men/1,485 women; aged, 1899 years) were examined. The incidence of type 2 diabetes among patients with MCD considering age and sex was determined.
 Results: Type 2 DM was detected in 407 patients with MCD (18.1%; male:female, 1:2.53). The polymorbidity index in male patients with type 2 diabetes was 1.52.0 times higher than that in male patients without diabetes. The rate of polymorbidity index increase was similar in both groups; however, its high initial value in patients with diabetes at a young age determined the burden of the comorbidity at a later age. In type 2 diabetes, hypertension was the predominant comorbidity at 1859 years of age (p0.05), whereas other cardiovascular diseases and liver and kidney diseases were predominant at 4574 years of age (p0.001) and hemiplegia at 4589 years of age (p0.05). Between 60 and 74 years, oncological diseases were found to be more common in patients without diabetes (p0.001). Obesity, regardless of the presence of diabetes, was associated with a greater disease burden (p0.05). Sex-related difference considering MCD in patients with type 2 DM was only observed for the higher incidence of myocardial infarction (p0.001) and peptic ulcer disease in males (p0.01). Females were more likely to have obesity, liver steatosis at a young age, or osteoarthritis than males in the general group (p0.05); no differences were noted with respect to other diseases.
 Conclusions: In this study, type 2 diabetes was present in 18.1% of patients with MCD; moreover, a high initial polymorbidity index in patients with T2DM at young age was associated with a higher incidence of chronic diseases later in life than that in patients without diabetes. Based on these results, type 2 diabetes, along with ageing and obesity, can be considered as a risk factor in the development of MCD.