ArticleJournal of general internal medicine2007
Beyond comorbidity counts: how do comorbidity type and severity influence diabetes patients' treatment priorities and self-management?
Article in Journal of general internal medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 171 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
171 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- A systematic review of glucocorticoid use in type 1 diabetes: Glycaemic effects and clinical management strategies.Diabetes, obesity & metabolism · 2026Pooled it
- 1. Improving Care and Promoting Health in Populations:Diabetes care · 2020Guideline
- Pooled it
- Standards of medical care in diabetes--2012.Diabetes care · 2012Guideline
- Transition to Virtual Diabetes Self-Management Education Delivery in the Setting of Health Care Disruption for Adults With Diabetes and Their Support Persons.The science of diabetes self-management and care · 2026Trial
- Trial
- Pre-Visit Prioritization for complex patients with diabetes: Randomized trial design and implementation within an integrated health care system.Contemporary clinical trials · 2016Trial
- Do older adults aged 60-75 years benefit from diabetes behavioral interventions?Diabetes care · 2013Trial
- Trial
- A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes.Nursing outlookTrial
- Unmet needs for social support and effects on diabetes self-care activities in Korean Americans with type 2 diabetes.The Diabetes educatorTrial
- Association between health-related quality of life and medication discrepancies: a cross-sectional study of older Chinese adults with type 2 diabetes mellitus.Health and quality of life outcomes · 2026Article
- Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors.Diagnostics (Basel, Switzerland) · 2026Review
- Machine learning and engagement insights for personalized blood glucose management.Frontiers in digital health · 2026Article
- Longitudinal insights into comorbidity patterns and burden among middle-aged and older adults with diabetes in China: a nine-year cohort study using CHARLS.Journal of global health · 2025Article
- Socio-Demographic, Environmental, and Clinical Factors Influencing Diabetes Mellitus Control in Community Pharmacies of Lahore Pakistan.Healthcare (Basel, Switzerland) · 2025Article
- Efficacy of SGLT2 Inhibitors, GLP-1 Receptor Agonists, DPP-4 Inhibitors, and Sulfonylureas on Moderate-to-Severe COPD Exacerbations Among Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Contribution of chronic conditions to mortality: Differences by race and ethnicity.Aging and health research · 2025Article
- Patient and family engagement in culturally-tailored diabetes self-management education in a Hispanic community.Patient education and counseling · 2025Article
- 1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
111 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe majority of older adults have 2 or more chronic conditions and among patients with diabetes, 40% have at least three.
objectiveWe sought to understand how the number, type, and severity of comorbidities influence diabetes patients' self-management and treatment priorities.
designCross-sectional observation study. PATIENTS: A total of 1,901 diabetes patients who responded to the 2003 Health and Retirement Study (HRS) diabetes survey. MEASUREMENTS: We constructed multivariate models to assess the association between presence of comorbidities and each of 2 self-reported outcomes, diabetes prioritization and self-management ability, controlling for patient demographics. Comorbidity was characterized first by a count of all comorbid conditions, then by the presence of specific comorbidity subtypes (microvascular, macrovascular, and non-diabetes related), and finally by severity of 1 serious comorbidity: heart failure (HF).
results40% of respondents had at least 1 microvascular comorbidity, 79% at least 1 macrovascular comorbidity, and 61% at least 1 non-diabetes-related comorbidity. Patients with a greater overall number of comorbidities placed lower priority on diabetes and had worse diabetes self-management ability scores. However, only macrovascular and non-diabetes-related comorbidities, but not microvascular comorbidities, were associated with lower diabetes prioritization, whereas higher numbers of microvascular, macrovascular, and non-diabetes-related conditions were all associated with lower diabetes self-management ability scores. Severe, but not mild, HF was associated with lower diabetes prioritization and self-management scores.
conclusionsThe type and severity of comorbid conditions, and not just the comorbidity count, influence diabetes patients' self-management. Patients with severely symptomatic comorbidities and those with conditions they consider to be unrelated to diabetes may need additional support in making decisions about care priorities and self-management activities.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.