Comorbidities are pathologies that are not directly related to the main ailment. They do not have their own complications, and they do not affect the development of the underlying disease.
How is the underlying disease and comorbidity related? This is a common question. It is worth looking into it in more detail.
Place in clinical diagnosis
A clinical diagnosis should have the following characteristics:
- The main disease, that is, the pathology that caused the last deterioration, and actually because of which the last hospitalization happened.
- Concomitant diseases, that is, a disease that differs in its pathogenesis in comparison with the main pathology, other causes of occurrence.
- A competing disease is a pathology that competes with the main one in terms of the degree of danger to the patient, but is not associated with the main disease in terms of the mechanism and causes of occurrence.
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Complications of the main disease - suchcomplications are pathogenetically associated with the underlying disease and are necessarily present in the structure of the clinical diagnosis.
- A background disease, that is, a pathology that is also not related to the main one in terms of the mechanism and causes of occurrence, but can significantly affect the prognosis and course of the main one.
Any disease (both competing, and concomitant, and the main one) should be reflected according to a single plan in the diagnosis. From the name of each pathology, as a rule, it is possible to establish the inflamed organ and the features of the pathogenic process.
With diabetes
Pathogenic factors contribute to the formation of diseases of the pancreas, kidneys and heart. In diabetes mellitus, the appearance of concomitant diseases worsens the condition of patients. Diabetes reduces the reparative and regenerative processes of the body, its immune defenses. The treatment of various diseases should be coordinated with sugar-lowering therapy.
So, below we will consider the most common diseases associated with diabetes.
Heart disease
The significance of diabetes mellitus and diseases of the internal organs of the patient in increasing mortality in old age is especially evident in pathologies of the vascular system. Stroke and heart attack are six times more likely to develop in people with diabetes than in other categories of patients.
Risk factors for heart disease, such as lipid disorders, obesity, hypertension, are very common in diabetics. Directlydiabetes becomes a risk factor for myocardial infarction in coronary heart disease. In this case, the treatment is as follows:
- ACE inhibitors: Captopril, Lisinopril, Ramipril, Enap.
- Angiotensin receptor blockers 2: Exforge, Teveten, Valsakor, Aprovel, Lorista, Micardis, Cozaar.
- Calcium channel blockers: Diltiazem, Nifidepin, Verapamil.
- Diuretics: Trifas, Furosemide.
- Imidiazoline receptor stimulants: Albarel, Physiotens.
Combined treatment of concomitant diseases with drugs of various types is mainly used.
Obesity due to diabetes
The connection of the second type of diabetes mellitus and obesity is due to the common causes of their appearance and the mutual increase in symptoms. High importance of dietary habits and heredity, unified metabolic processes lead to the conclusion about the reduction of excess body weight for the treatment of diabetes.
In addition to the cosmetic defect, due to obesity, the functioning of internal organs is disrupted, which manifests itself in the form:
- myocardiopathy and coronary disease;
- digestive disorders - pancreatitis and gallstone disease;
- fatty liver disease;
- articular pathologies; woman not having her period;
- lack of male potency;
- severe nature of hypertension.
There is such a way to overcome your addiction to carbohydrates, like eating for three to four weeks of chromiumpicolinate. In addition, treatment is carried out with drugs that reduce sugar: Glucobay, Metformin. In patients with high production of their own insulin, insulin replacement therapy, even with a high degree of hyperglycemia, is not indicated.
The most effective remedy for previous and concomitant disease in reducing the patient's sugar level and weight is a low carbohydrate diet.
Fatty liver disease and diabetes
When the composition of the blood changes (accumulation of metabolic, medicinal, bacterial toxins), the liver reacts to them with fatty deposits in the cells. A similar process can occur with strict vegetarianism, fasting, intestinal malabsorption and alcohol intoxication.
In diabetes, there is an excessive production of ketone bodies due to a violation of carbohydrate metabolism. They can accumulate in the liver tissues.
With obesity, which accompanies diabetes, fatty hepatosis occurs much more often, it is one of the symptoms of dysmetabolic syndrome.
Treatment of a concomitant disease in the form of fatty liver is carried out by a diet that includes lipotropic foods: fish, oatmeal, seafood, cottage cheese, kefir, soybeans, cold-pressed vegetable oil, yogurt.
Promotes the removal of excess cholesterol and fat food containing pectin and fiber. Therefore, the menu should be vegetables in large quantities. If the patient is prone to constipation, it is advisable to add bran to dishes.
Hepatoprotectors are used among the drugs: Berlition, Gepabene, Glutargin, Essliver and Essentiale.
Infectious diseases
Diabetes mellitus is characterized by a reduced immune response, making patients vulnerable to viruses, bacteria, and fungal infections. Such diseases are characterized by severe and frequent course. Infections destabilize diabetes.
Common concomitant diseases of an infectious nature: pyelonephritis, pneumonia, diabetic ketoacidosis (against the background of pneumonia).
Antibiotics are prescribed only intravenously or intramuscularly: Levofloxacin, Ceftriaxone, Ciprofloxacin.
With antibiotics, antifungals must be used to prevent candidiasis.
One of the common infections in diabetes mellitus is candidiasis of the mucous membranes and integuments of the skin. Treatment of candidiasis is carried out locally, with the use of ointments against the fungus and suppositories in women. Local use is combined with the course reception of "Fluconazole". If resistance to it develops, then they switch to Ketoconazole or Itraconazole.
TB and associated diseases
The issue of the combination of tuberculosis with other diseases is of particular importance when it comes to the so-called persons from the “high risk” group, primarily chronic alcoholics and drug addicts. The presence of other pathologies in a person suffering from tuberculosis negatively affects its course, worsens the prognosis, and limits therapeutic measures. Concomitant diseases are found in 86 percent of the sections of people who die from tuberculosis. In persons over 50 years of age, the same figure reaches 100%, in patients with fibrous-cavernous tuberculosis it rises to 91%.
The following diseases are especially common with TB:
- AIDS and HIV infection
- non-specific chronic lung disease;
- diabetes mellitus;
- lung cancer;
- cardiovascular pathology;
- alcoholism;
- liver disease;
- pregnancy;
- duodenal ulcer and stomach ulcer;
- disorders of the neuropsychiatric type.
These diseases are also a risk factor for the appearance of tuberculosis, and therefore each of them requires careful attention of patients, medical consultations and competent treatment.
Disability
Disability refers to a person's condition when it is impossible to carry out mental, physical or mental activity. This status is determined by a number of groups:
- circulatory diseases;
- pathologies of motor functions;
- violations of metabolic processes;
- diseases of the respiratory and digestive systems;
- mental disorders; defects in the activity of the sense organs: touch, smell, hearing, vision.
Disability from concomitant diseases and various complications can be obtained.
