Type 2 Diabetes and Comorbid Conditions: Why It’s Often More Than Blood Sugar That Needs Attention
More than 37 million Americans are living with diabetes, and the overwhelming majority of them are managing Type 2 diabetes. If you’re among them, chances are managing blood sugar is not the only challenge on your daily health and wellness agenda. This is because managing Type 2 diabetes almost always involves dealing with other conditions known as comorbidities.
What is comorbidity?
A comorbidity is a physical or mental disease or condition that coexists with a primary disease. Essentially, the primary disease a person is facing is either intrinsically associated with another health concern, can elevate the risk of experiencing another health concern, or be worsened by a related comorbid health problem.
A recent study of more than 1.3 million individuals showed that nearly 98% of people living with Type 2 diabetes are also dealing with at least one comorbid condition or chronic disease. Even more telling, an astonishing 90% are dealing with at least two comorbid conditions, known as facing multimorbidities.
So, what are the comorbidities associated with Type 2 diabetes? In this post, we’ll examine some of the more common comorbid conditions associated with the disease and some that seem to be less talked about. If you have Type 2 diabetes, there’s a better-than-good chance you’re living with at least one of these health concerns. Understanding the relationships between comorbidities and working closely with your diabetes physician and care team can positively impact your diabetes treatment and overall health and well-being.
Comorbidities Associated with Type 2 Diabetes
Obesity
This is an example of comorbidity that isn’t caused by the disease but instead is often a significant factor contributing to the disease. Obesity is defined as carrying excess weight or body fat on a level that negatively impacts health. Medically, obesity is described as having a body mass index (BMI) of 30 kg/m or more. There is evidence that points to the fact that about 90% of people with Type 2 diabetes are also facing obesity, so there clearly is some connection. It’s been shown that carrying too much weight can increase a person’s insulin resistance and negatively impact the function of beta cells in the pancreas, which are both directly related to the development of Type 2 diabetes.
The thing about obesity is that it is a comorbidity that an individual can manage to a great degree with diet and exercise. Not only is losing excess weight beneficial to overall health, but it will also almost certainly improve blood sugar control and diabetes management. In some cases, losing weight can even help reverse Type 2 diabetes.
Dyslipidemia
According to a cross-sectional study published in 2021, about 32% of individuals with Type 2 diabetes also had issues with Dyslipidemia. What is it? Dyslipidemia is an imbalance of fatty substances known as lipids – most of us simply know it as high cholesterol. High cholesterol occurs due to an increased level of low-density lipoproteins (LDL cholesterol), commonly called bad cholesterol. However, dyslipidemia can also involve low levels of good cholesterol or high-density lipoproteins. This condition shares many of the same risk factors as Type 2 diabetes, including obesity.
Hypertension
How is high blood pressure associated with Type 2 diabetes? Elevated blood sugar associated with diabetes can also cause damage to the body’s blood vessels, causing resistance in the arteries to become more prevalent, which in turn causes body fluid volume to increase and elevate blood pressure. According to the American Diabetes Association (ADA), about 2 out of every 3 people living with Type 2 diabetes will report having high blood pressure, with many taking prescribed medication to help control it.
Cardiovascular Disease
This comorbidity is linked to both diabetes and hypertension. Because an elevation in blood sugar can damage blood vessels and even lead to a hardening of the arteries, it can eventually cause damage to the heart. Add hypertension to the equation, and the risk of heart damage is compounded. Approximately 30% of people who have Type 2 diabetes are also battling heart disease. Additionally, someone living with Type 2 diabetes is twice as likely to develop heart disease or have a stroke as someone without the disease, and the Centers for Disease Control and Prevention (CDC) points out that a person with Type 2 diabetes is more likely to suffer heart failure, a condition in which the heart becomes unable to effectively pump blood, leading to issues such as swelling in the legs, fluid in the lungs and difficulty breathing.
Cardiovascular disease is arguably the most serious comorbidity, representing the number one cause of death among people with Type 2 diabetes.
Kidney Disease
The high blood sugar associated with Type 2 diabetes can damage the kidneys, which are responsible for filtering waste products and excess fluids from the body. The kidneys also regulate blood pressure (hypertension), once again furthering the comorbidity web. According to the National Kidney Foundation, Type 2 diabetes is the principal cause of kidney failure in the United States.
Metabolic Dysfunction-Associated Liver Disease (MASLD)
This form of liver disease, entirely unrelated to alcohol consumption, occurs due to an accumulation of fat, which causes the liver to enlarge and its enzymes to become elevated. Again, multimorbidities can come into play, with obesity playing a significant factor and MASLD often developing as a result of or alongside Type 2 diabetes. On the plus side, many lifestyle changes that can be used to lower the risk of diabetes can also lower the risk of MASLD, such as losing weight, physical activity, and consistently eating a low-sugar, low-fat diet.
Mental Health Issues
While this one is a little different than a biological or medical relationship, there is no doubt that mental health and Type 2 diabetes are often intertwined. The rigors that come with managing diabetes on a daily basis – planning for healthy meals, testing blood sugar multiple times each day, dealing with blood glucose highs and lows, administering insulin, struggling with weight, and so much more, can put immense pressure on a person. According to the CDC, people with diabetes are 2-3 times more likely to develop depression than those without the disease. Worse, they often find themselves facing a vicious circle. The challenges of diabetes management lead to mental health issues, which in turn make it more difficult to manage diabetes effectively.
If you or someone you love is struggling with mental or emotional issues related to diabetes management, please seek help. Speak with your doctor or contact a therapist who specializes in diabetes-related mental health concerns.
Preventing Type 2 Diabetes-Related Comorbidities
The truth is once you have been diagnosed with Type 2 diabetes, your risk of experiencing many comorbidities increases. Conversely, once you are facing specific comorbidities like obesity, your risk of developing Type 2 diabetes increases. So, what can you do?
As someone already living with Type 2 diabetes, the best thing you can do is keep it well-managed so you’re able to maintain your blood sugar in the target range as consistently as possible.
This means eating right, exercising, watching your weight, testing your blood sugar regularly, and taking your prescribed medications. These activities are not only good for controlling your diabetes but also for reducing the risk of most comorbidities.
Put it this way. By taking good care of your Type 2 diabetes, you’re taking care of a lot more.
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