{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T16:40:33Z","timestamp":1759509633590,"version":"build-2065373602"},"reference-count":16,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[1991,3]]},"abstract":"<jats:p>STUDY OBJECTIVE--The aim was to examine disease concurrence, using diabetes mellitus as an ullustrative example. DESIGN--The study involved a general practice morbidity survey, conducted over 12 months in 1981-82. All patients who consulted their general practitioners with a diagnosis of diabetes mellitus (type 1 or type 2) were identified and the number of these who consulted with additional morbidities were counted for each rubric of the Royal College of General Practitioners' modification of the International Classification of Disease. These observed numbers were then compared with expected numbers calculated from the total non-diabetic population after standardisation by age. Standardised person consulting ratios (SPCR) were derived and the 99% confidence intervals (CI) surrounding these values calculated. SETTING--This was a national survey involving the whole of England and Wales. PATIENTS--The study involved 280,000 patients from selected general practices, of whom 953 males and 1035 females consulted their general practitioners with diabetes. MEASUREMENTS AND MAIN RESULTS--In an examination of 80 disease rubrics in the diabetic population in which there were at least 20 observed or expected cases, there were 34 among males and 28 among females in which there were increased values of the SPCR, and none in which the SPCR was decreased. SPCRs were high for infections generally (bacterial, fungal, and viral) and particularly so for cardiovascular disorders and for hypothyroidism in males. Though SPCRs for upper respiratory infections were increased, those for asthma and hay fever were not. SPCRs for neoplasms as a group were not raised. CONCLUSION--By confirming other work and widely held clinical opinion, this study has shown the potential of this data base for the examination of disease concurrence.<\/jats:p>","DOI":"10.1136\/jech.45.1.73","type":"journal-article","created":{"date-parts":[[2008,11,12]],"date-time":"2008-11-12T15:10:54Z","timestamp":1226502654000},"page":"73-77","source":"Crossref","is-referenced-by-count":12,"title":["Disease concurrence in diabetes mellitus: a study of concurrent morbidity over 12 months using diabetes mellitus as an example."],"prefix":"10.1136","volume":"45","author":[{"given":"D M","family":"Fleming","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D L","family":"Crombie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K W","family":"Cross","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1991,3,1]]},"reference":[{"key":"ref_1","first-page":"609","article-title":"Birmingham Research Unit of the Royal College of General Practitioners. \"The Diagnostic Index\"","volume":"21","year":"1971","unstructured":"Birmingham Research Unit of the Royal College of General Practitioners. \"The Diagnostic Index\" J Roy Coll Gen Pract 1971; 21: 609-12.","journal-title":"J Roy Coll Gen Pract"},{"key":"ref_2","article-title":"Morbidity statistics from general practice-Third national study 1981-1982. A publication ofthe Government Statistical Service. Series MB5 No 1","author":"Royal College of General Practitioners, Office of Population Censuses and Surveys, Department of Health and Social Security","year":"1986","unstructured":"Royal College of General Practitioners, Office of Population Censuses and Surveys, Department of Health and Social Security. Morbidity statistics from general practice-Third national study 1981-1982. A publication ofthe Government Statistical Service. Series MB5 No 1. London: HMSO, 1986."},{"key":"ref_3","first-page":"78","article-title":"US Dept of Health Education and Welfare. Diabetes data: compiled 1977","author":"Publication No (NIH","unstructured":"US Dept of Health Education and Welfare. Diabetes data: compiled 1977. Publication No (NIH) 78-1468."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/S0140-6736(77)92071-2","article-title":"Classification ofidiopathic diabetes","volume":"i:","author":"Irvine, W.J.","year":"1977","unstructured":"Irvine WJ. Classification ofidiopathic diabetes. Lancet 1977; i: 638-42.","journal-title":"Lancet"},{"key":"ref_5","article-title":"Epidemiology of diabetes and its vascular lesions","author":"West, K.M.","year":"1978","unstructured":"West KM. Epidemiology of diabetes and its vascular lesions. New York: Elsevier North Holland, 1978."},{"key":"ref_6","first-page":"1497","article-title":"College ofGeneral Practitioners. A diabetes survey. Report of a working party","volume":"1962","unstructured":"College ofGeneral Practitioners. A diabetes survey. Report of a working party. Br MedJ7 1962; i: 1497-503.","journal-title":"Br MedJ7"},{"key":"ref_7","article-title":"Infection in patients with diabetes mellitus or obesity","volume-title":"mellitus and obesity","author":"Tofte, R.W.; Sabath, L.D.","year":"1982","unstructured":"Tofte RW, Sabath LD. Infection in patients with diabetes mellitus or obesity. In: Brodoff BN, Bleicher SJ, eds. Diabetes mellitus and obesity. Baltimore: Williams and Wilkins, 1982."},{"key":"ref_8","first-page":"161","article-title":"The role of viruses in the pathogenesis of pancreatic disease and diabetes mellitus","volume":"19","author":"Craighead, J.E.","year":"1975","unstructured":"Craighead JE. The role of viruses in the pathogenesis of pancreatic disease and diabetes mellitus. Prog Med Virol 1975; 19: 161-214.","journal-title":"Prog Med Virol"},{"issue":"265","key":"ref_9","first-page":"1128","article-title":"Studies of the epidemiology of staphylococcal infection. III. Clinical factors in susceptibility to disease","volume":"1961","author":"Keene, W.R.; Minchew, B.H.; Cluff, L.E.","unstructured":"Keene WR, Minchew BH, Cluff LE. Studies of the epidemiology of staphylococcal infection. III. Clinical factors in susceptibility to disease. N EnglJ Med 1961; 265: 1128-34.","journal-title":"N EnglJ Med"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1002\/bjs.1800560512","article-title":"The association between carcinoma of the pancreas and diabetes mellitus","volume":"56","author":"Karmody, A.J.; Kyle, J.","year":"1969","unstructured":"Karmody AJ, Kyle J. The association between carcinoma of the pancreas and diabetes mellitus. Br J Surg 1969; 56: 362-4.","journal-title":"Br J Surg"},{"key":"ref_11","first-page":"163","article-title":"Thyroid and gastric autoimmunity in patients with diabetes mellitus","volume":"ii:","author":"Irvine, W.J.; Clarke, B.F.; Scarth, L.; Cullen, D.R.; Duncan, L.J.P.","year":"1970","unstructured":"Irvine WJ, Clarke BF, Scarth L, Cullen DR, Duncan LJP. Thyroid and gastric autoimmunity in patients with diabetes mellitus. Lancet 1970; ii: 163-8.","journal-title":"Lancet"},{"key":"ref_12","first-page":"221","article-title":"Unrecognised thyroid failure in diabetes mellitus","volume":"2","author":"Gray, R.S.; Irvine, W.J.; Toft, D.A.; Seth, J.; Cameron, E.H.D.; Clarke, B.F.","year":"1979","unstructured":"Gray RS, Irvine WJ, Toft DA, Seth J, Cameron EHD, Clarke BF. Unrecognised thyroid failure in diabetes mellitus. J Clin Lab Immunol 1979; 2: 221-4.","journal-title":"J Clin Lab Immunol"},{"key":"ref_13","article-title":"Ocular complications of diabetes mellitus","volume-title":"mellitus and obesity","author":"Bresnick, G.H.","year":"1982","unstructured":"Bresnick GH. Ocular complications of diabetes mellitus. In: Brodoff BN, Bleicher SJ, eds. Diabetes mellitus and obesity. Baltimore: Williams and Wilkins, 1982."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1902\/jop.1964.35.6.476","article-title":"Influence of diabetes mellitus on the severity of periodontal disease","volume":"35","author":"Belting, C.M.; Hiniker, J.J.; Dummett, C.O.","year":"1964","unstructured":"Belting CM, Hiniker JJ, Dummett CO. Influence of diabetes mellitus on the severity of periodontal disease. J Periodontol 1964; 35: 476-80.","journal-title":"J Periodontol"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1136\/gut.19.12.1153","article-title":"Progress report: diabetes and the gut","volume":"19","author":"Scaparello, J.H.B.; Sladen, G.E.","year":"1978","unstructured":"Scaparello JHB, Sladen GE. Progress report: diabetes and the gut. Gut 1978; 19: 1153-62.","journal-title":"Gut"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/j.0954-6820.1966.tb05445.x","article-title":"Studies in urinary tract infections in diabetes. I. Bacteriuria in patients with diabetes mellitus and in control subjects","volume":"179","author":"Vejsgaard, R.","year":"1966","unstructured":"Vejsgaard R. Studies in urinary tract infections in diabetes. I. Bacteriuria in patients with diabetes mellitus and in control subjects. 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