Journal article
Diabetes Complications Among Community-Based Health Center Patients with Varying Multimorbidity Patterns
Journal of general internal medicine : JGIM, Vol.40(6), pp.1350-1358
05/2025
DOI: 10.1007/s11606-025-09457-y
PMCID: PMC12045846
PMID: 40035965
Abstract
Multimorbidity with diabetes mellitus (DM and ≥ 1 chronic disease) presents challenges to maintaining adequate DM control.
This study evaluates the risk of DM-related complications associated with various multimorbidity/DM patterns for patients seen in community-based health centers (CHCs).
Retrospective cohort study from the ADVANCE multi-state practice-based clinical data network.
Study included data from 132,765 patients age ≥ 45 years with DM seen in 2493 CHCs across 26 states from 10/01/2015 to 12/31/2019.
We assessed accrual of conditions and risk of experiencing DM complications during follow-up. Primary outcome of DM complication was categorized into acute, microvascular, microvascular (end-stage), macrovascular, or other. Key exposures included mutually exclusive multimorbidity categories: (1) DM + cardiometabolic, (2) DM + other somatic, (3) DM + mental, (4) DM + mental + somatic.
At baseline, 17.2% of patients had DM only, 55.0% had DM + cardiometabolic multimorbidity, 2.3% had DM + other somatic multimorbidity, 3.0% had DM + mental multimorbidity, and 22.5% had DM + mental + somatic multimorbidity. Most DM-only patients (76.5%) developed multimorbidity with DM by study end. Compared with DM-only, adjusted risk differences of DM complications ranged from 1.4% (acute) to 8.8% (microvascular). DM + mental + somatic multimorbidity was associated with 13.4% (95%CI 12.8-14.1%) higher adjusted risk of experiencing any DM complication.
CHCs care for increasingly complex populations of patients with DM. Tailoring disease management strategies to address comorbid cardiovascular and/or mental health conditions may be important to prevent acute, microvascular, and macrovascular complications in these settings.
Details
- Title: Subtitle
- Diabetes Complications Among Community-Based Health Center Patients with Varying Multimorbidity Patterns
- Creators
- Ana R Quiñones - Oregon Health & Science UniversityJun Hwang - Oregon Health & Science UniversityNathalie Huguet - Oregon Health & Science UniversityCharisse Madlock-Brown - University of IowaMiguel Marino - Oregon Health & Science UniversityRobert Voss - OchinCharles GarvenDavid A Dorr - Oregon Health & Science University
- Resource Type
- Journal article
- Publication Details
- Journal of general internal medicine : JGIM, Vol.40(6), pp.1350-1358
- DOI
- 10.1007/s11606-025-09457-y
- PMID
- 40035965
- PMCID
- PMC12045846
- NLM abbreviation
- J Gen Intern Med
- ISSN
- 1525-1497
- eISSN
- 1525-1497
- Publisher
- SPRINGER
- Grant note
- R01AG061386 / NIA NIH HHS U18DP006536 / NIDDK NIH HHS
- Language
- English
- Electronic publication date
- 03/04/2025
- Date published
- 05/2025
- Academic Unit
- Nursing
- Record Identifier
- 9984797818502771
Metrics
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