TUESDAY, July 23 (HealthDay News) -- A new review finds that
people with diabetes face more than a 50 percent higher risk of
disability than people without the blood sugar disease.
Disability includes trouble walking, using a telephone, managing
finances, shopping and even bathing, dressing and eating.
"We found that diabetes increased the risk of disability by 50 percent to 80 percent compared to those without diabetes, and this result was consistent across all types of disability," said review senior author Anna Peeters, head of obesity and population health at Baker IDI Heart and Diabetes Institute in Melbourne, Australia.
"The results of this study are particularly important in the context of an aging population and increasing diabetes prevalence over time," she said. "In combination, this suggests a substantial increase in the burden of disability in the elderly in coming decades."
Peeters said it isn't clear exactly how diabetes contributes to
the increased risk of disability, but she did point out that
researchers controlled the data to account for other factors that
are common to both diabetes and disability, such as obesity and a
sedentary lifestyle, and they still found a link between diabetes
She said it's possible that the inflammation associated with
high blood sugar levels may contribute to disability, or it's
possible that diabetes complications, such as heart disease, kidney
problems and limb amputations, may add to the disability risk.
Results of the study were published online July 23 in the
The Lancet Diabetes and Endocrinology.
During the past three decades, the incidence of diabetes has
more than doubled, according to background information in the
review. That means approximately 347 million adults worldwide had
diabetes in 2008. Complications of diabetes can include heart
disease, vision problems, kidney disease and blood vessel disease
in the extremities, according to the review.
Studies looking at the risk of disability in people with
diabetes have had mixed results. Some have shown no link, while
others have found a doubling of disability risk.
To get a better idea of what the actual risk might be, Peeters
and her colleagues reviewed data from 26 studies that compared the
risk of disability in people with and without diabetes.
They found that the odds of someone with diabetes having a
mobility disability, such as trouble walking, were 71 percent
higher than for someone without diabetes. The chances of someone
with diabetes having trouble with using the phone, shopping or
using transportation were 65 percent higher. And the odds that
someone with diabetes would have difficulty with eating, dressing
and bathing were 82 percent higher, according to the review.
Peeters said the studies didn't break down diabetes by type, but
she said it's likely that most had type 2 diabetes.
In addition, she said, few studies looked at the effect of
diabetes management on the risk of disability, so it isn't clear if
well-managed diabetes provides protection against disability. She
said, however, that in the few studies that looked at diabetes
management, poor control of blood sugar levels appeared to increase
the risk of disability.
"We know that good control of diabetes decreases the risk of known major complications and those complications are, in turn, associated with future disability," Peeters said. "It is therefore highly likely that good diabetes control will decrease one's risk of disability."
One expert said the findings did not prove a cause-and-effect
link between diabetes and an increased risk of disabilities.
"I don't think this study shows a clear connection between diabetes and disability, although it is a good effort in starting to think about the subject and it increases awareness for physicians," said Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. "But there are still many questions to be answered."
Another expert agreed.
For example, the review doesn't look at the differences in
disability based on the severity or duration of diabetes, said Dr.
Joel Zonszein, director of the clinical diabetes center at
Montefiore Medical Center in New York City.
Zonszein also noted, however, that the study "illustrates, as
expected, how diabetes, when not diagnosed and treated properly,
can cause disabilities, with a high cost to the patient, the
family, society and a burden to the health care system."
"This study adds to others that show, from a public-health-policy perspective, the importance of shifting monies from treating complications and disability to investing in disease prevention, and early diagnosis and treatment," he said.
Learn more about treating diabetes from the
American Diabetes Association.
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