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When Diabetes Is Not Your Only Health Concern

By Theresa Garnero, APRN, BC-ADM, MSN, CDE

If diabetes is your only chronic condition, count your blessings.

Simultaneously managing multiple chronic illnesses affects 25% of the population; 65% of the Medicare population has two or more lifelong health issues. dLife readers have shared many examples of the competing priorities when juggling a variety of conditions in addition to diabetes:

• High blood pressure, high cholesterol, anemia
• Chronic pain, Hepatitis-C, depression
• Multiple sclerosis
• Gout (some foods that are OK for diabetes are bad for gout)
• Arthritis, asthma, and Celiac disease
• Seasonal adjustment disorder, breast biopsy
• Insomnia, night time foot cramps
• Celiac disease, heart disease (stent implanted), and spinal stenosis
• Lupus, lung cancer, rheumatoid arthritis, thyroid problems, chronic back pain
• Sarcoidosis, fibromyalgia

These diseases are challenging even on good days let alone being added to the mix of diabetes. How do you manage a multitude of health conditions, improve your care, and decide what is a priority? According to the Chronic Care Model, elements required to improve care of chronic illnesses include an optimal delivery design within healthcare organizations that support clinical information, community resources, and self-care management decisions. The healthcare system has a long way to go to coordinate care across a multitude of providers. For instance, if you see a specialist and have another issue not directly related to that specialty, it is common to refer to another doctor. This may lead to adverse medication reactions if one provider is not clear what the other has ordered. Given the complexity of living with ongoing, and often competing disease states, the coordination of care often falls on the individual seeking care and their support team — certainly not ideal, but the reality.