Most people who have diabetes, high blood pressure, and high cholesterol have difficultly managing all three conditions; indeed, success is fleeting for those who do manage all three, according to a Kaiser Permanente Institute for Health Research study that appears online in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.
The study of close to 29,000 individuals enrolled at Kaiser Permanente Colorado and Denver Health found that only 30.3 percent at Kaiser Permanente and 16.2 percent of individuals at Denver Health were able to simultaneously control their diabetes, hypertension, and hyperlipidemia (high cholesterol), as measured by risk factor control guidelines defined by the American Diabetes Association. But among those individuals that achieved simultaneous control of their conditions, few were able to maintain it at either institution.
Specifically, the study found that among those individuals with at least 90 days of follow-up after achieving simultaneous control, 39 percent from Kaiser Permanente and 23 percent from Denver Health subsequently lost and then regained control, and 56 percent and 64 percent lost control and never regained it. Only 5 percent at Kaiser Permanente and 13 percent at Denver Health never lost control of their chronic conditions--efforts to understand the strategies used by these individuals to care for their diabetes may provide insight into improving self-care and health outcomes, according to the researchers.
The researchers defined risk factor control using the 2002 guidelines from the American Diabetes Association, which were in place for the majority of the study period.
"Diabetes and other chronic conditions associated with it are very difficult but not impossible diseases to manage, for reasons we're just beginning to understand," said Emily B. Schroeder, MD, PhD, a research scientist with the Kaiser Permanente Institute for Health Research and the lead author of the study. "This research tells us to look more closely at how certain patients are able to control their multiple conditions, so clinicians can help patients recover and avoid greater risks of developing other ailments, including cardiovascular and kidney disease."