The most common concordant comorbidity was hypertension while depression was the most common discordant condition .
Adherence to medications was the most frequent diabetes self-care behavior reported and tended to be higher among concordant comorbidities .
The findings showed mixed results concerning the effect of some concordant comorbidities such as hypertension , hyperlipidemia , retinopathy , and heart failure on diabetes self-care behaviors .
But , there is agreement across studies that diabetes-discordant comorbidities have a more detrimental effect on self-care behaviors .
Conclusions : Concordant comorbidities may improve diabetes self-care , but the evidence is inconclusive .
Background : Most patients with Type 2 diabetes ( T2D ) have high number of comorbid chronic conditions that can affect their self-care abilities .
Guidelines for diabetes self-care behaviors are disease specific with little attention given to managing T2D with other comorbidities .
Identifying comorbidities that either improve or potentially diminish the individual 's capacity to perform effective self-care behaviors is essential to enhance clinical outcomes .
One such framework conceptualizes comorbidities as concordant or discordant with diabetes pathophysiological pathways and care goals .
Objective : The purpose of this systematic review was to examine the role of diabetes-concordant and discordant chronic conditions on the performance of self-care behaviors in adults with T2D .
Adherence to diabetes self care for white, African-American and Hispanic American telemedicine participants: 5 year results from the IDEATel project
Objectives . Adherence to diabetes self care is poor for Hispanic American and African-American patients . This study examined the change in adherence over time and in response to a telemedicine intervention for elderly diabetes patients in these groups compared to white diabetes patients . We also examined whether adherence mediated the effect of the intervention on glycemic control ( A1c ) . Design . The Informatics for Diabetes Education and Telemedicine project r and omized medically underserved Medicare patients ( n=1665 ) to telemedicine case management ( televideo educator visits , individualized goal - setting /problem solving ) or usual care .  Hispanic and African-American educators delivered the intervention in Spanish if needed . Main outcome measures . Annual assessment included A1c and self-reported adherence ( Summary of Diabetes Self-Care Activities scale ) . A simple model ( only time and group terms ) and a model with covariates ( e.g. , age ) were examined for baseline and 5 years of follow-up . SAS PROC Mixed was used with non-linear terms to examine mediating effects of adherence on A1c , by performing tests of the mediating path coefficients . Results . Over time , self-reported adherence improved for the treatment group compared to usual care ( p<0.001 ) . There was no significant interaction with racial/ethnic group membership , i.e. , all groups improved . However , minority subjects were consistently less adherent than whites . Also , greater comorbidity and diabetes symptoms predicted poorer adherence , greater duration of diabetes and more years of education predicted better adherence . Adherence was a significant mediator of A1c ( p<0.001 ) . Conclusions . A unique , tailored telemedicine intervention was effective in achieving improved adherence to diabetes self care . However , African-American and Hispanic American participants were less adherent than white participants at all time points despite an individualized and accessible intervention . The finding that adherence did mediate glycemic control suggests that unique interventions for minority groups may be needed to overcome this disparity
The most common concordant comorbidity was hypertension while depression was the most common discordant condition .
Adherence to medications was the most frequent diabetes self-care behavior reported and tended to be higher among concordant comorbidities .
The findings showed mixed results concerning the effect of some concordant comorbidities such as hypertension , hyperlipidemia , retinopathy , and heart failure on diabetes self-care behaviors .
But , there is agreement across studies that diabetes-discordant comorbidities have a more detrimental effect on self-care behaviors .
Conclusions : Concordant comorbidities may improve diabetes self-care , but the evidence is inconclusive .
Background : Most patients with Type 2 diabetes ( T2D ) have high number of comorbid chronic conditions that can affect their self-care abilities .
Guidelines for diabetes self-care behaviors are disease specific with little attention given to managing T2D with other comorbidities .
Identifying comorbidities that either improve or potentially diminish the individual 's capacity to perform effective self-care behaviors is essential to enhance clinical outcomes .
One such framework conceptualizes comorbidities as concordant or discordant with diabetes pathophysiological pathways and care goals .
Objective : The purpose of this systematic review was to examine the role of diabetes-concordant and discordant chronic conditions on the performance of self-care behaviors in adults with T2D .