Multiple Chronic Health Conditions: Interrelationship between Diabetes and Arthritis and Barriers to Physical Activity

As researchers gather information about leading chronic diseases in the United States, their analyses show that “35 percent of men and 45 percent of women ages 60 to 69 have two or more chronic health conditions. For people in their 70s, the percentages are 47 percent for men and 61 percent for women. And the percentages increase even further after age 80” (Arthritis Today, from the National Health Survey by CDC). Medically, this is called co-morbidity, meaning the presence of more than one health problem in the same person. “Dealing with a chronic health problem is difficult at any age. But when a second or third problem occurs, it’s an added blow. Pain may be heightened, disability more dramatic, fatigue more debilitating and health care hassles multiplied” (Arthritis Today).

Data from the National Center for Health Statistics indicate that more than half of adults with diagnosed diabetes also have arthritis. In the 45-64 age group, arthritis strikes 51.8% of people with diabetes and 36.4% of the general population. Arthritis afflicts 62.4% of diabetes patients 65 and older as compared to 56.2% of those without diabetes. In other words, more than half of people with diabetes also suffer with arthritis. CDC researchers find that this interrelationship occurs in other age groups. “Diabetes patients aged 18 to 44 have a 27.6% chance of having arthritis – 2.5 times the 11% rate seen in the general population” (CDC, May 2008).

Suggested reasons for occurrence of co-morbidity:

• Mechanisms behind various diseases may be related (e.g., inflammatory diseases such as rheumatoid arthritis and coronary artery disease).
• Systemic forms of arthritis (e.g., rheumatoid arthritis and lupus) affect different organs causing problems with the heart, lungs, skin, liver, and kidneys.
• Medications given for one chronic disease may contribute to another (e.g., prednisone, a corticosteroid, in high doses is associated with premature development of osteoporosis). The current average number of medications for clients at St. Joseph Hospital’s Adult Day Care is 16.
• Advanced age can put a person at risk for co-morbidity.

The study, Arthritis as a Potential Barrier to Physical Activity among Adults with Diabetes: United States, 2005 and 2007, found the presence of arthritis acts as an additional barrier to physical activity among those with diabetes. Data showed that “29.8 percent of adults with arthritis and diabetes were inactive, compared with 21.0 percent of people with diabetes alone, 17.3 percent of those with arthritis alone, and 10.9 percent of adults with neither condition.” “Adults with arthritis and diabetes have unique barriers to being physically active such as concerns about pain, aggravating or worsening joint damage, and not knowing how much or what types of physical activity are safe for them” (Morbidity and Mortality Weekly Report. May 8, 2008 MMWR). For general information about diabetes, visit CDC′s Diabetes Public Health Resource Web site at http://www.cdc.gov/diabetes .

Living with two or more chronic health problems often requires a person to work with different medical doctors and clinics and with a variety of treatments and medications. Suggested strategies (from Arthritis Today) for managing chronic health conditions include:

• find one doctor to manage your care who willingly corresponds with your other doctors
• select doctors located at same medical center
• use one pharmacy
• keep a notebook of symptoms and medications
• ask questions about illnesses and educate yourself about your health conditions
• stay physically active and choose exercises that your body can do
• be flexible in finding new ways to enjoy favorite activities; pace yourself and seek support

No problem can stand the assault of sustained thinking (Chinese fortune cookie quote)

Myth or Fact: Extra vitamins give the body more pep and energy. Yes? No?     Look for the answer elsewhere in this Newsletter..

Answer to statement that taking extra vitamins boosts energy levels. This is a myth. Vitamins by definition are carbon-containing substances needed in small amounts to help promote and regulate chemical reactions and processes in the body. Vitmains provide no energy to the body directly. They do help unleash energy stored in carboyhydrates, proteins, and fats.