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(May 21, 1998 00:56 a.m. EDT http://www.nando.net) -- Doctors treating patients for serious chronic diseases such as diabetes or emphysema often neglect lesser conditions like thinning bones and arthritis, a new research study says. The researchers said some doctors may fall victim to a common fallacy: that patients with one chronic disease are unlikely to suffer from another. "Mother Nature has no mercy. As a consequence, the presence of one disease usually provides no immunity against others," the researchers wrote. "Our findings suggest a shortfall in health care -- specifically, that unrelated disorders are relatively neglected in patients with chronic medical diseases." The study, published in Thursday's New England Journal of Medicine, looked at a prescription drug database for 1.34 million residents of Ontario, Canada, who were 65 or older in 1995. All of the patients could get free prescription drugs through a government program. The researchers identified patients with three chronic diseases -- diabetes, emphysema or psychosis -- by the drugs prescribed for them: insulin, ipratropium bromide or haloperidol. Then they looked at the patients to see if they were getting drugs for other, unrelated ailments. Women suffering from diabetes were found to be 60 percent less likely than those without it to be given estrogen, which helps prevent osteoporosis and heart disease. Patients with emphysema were 31 percent less likely to get cholesterol-lowering drugs, and those with psychosis were 41 percent less likely to get arthritis drugs. Dr. Frank Vinicor, director of diabetes research at the U.S. Centers for Disease Control and Prevention, said he was not surprised by the findings, for two reasons: Managed care is resulting in shorter patient visits, and there are many new treatments for diabetes and other chronic diseases. Doctors "very logically are spending most of their effort on diabetes-related issues, and have even less time to spend now on unrelated chronic problems that could be effectively treated," he said. The researchers could not determine whether doctors failed to diagnose these secondary conditions, or whether they diagnosed them but decided not to treat them because of concerns about side effects, drug interactions or resistance from the patient. "Patients with chronic diseases may be exhausted and reluctant to accept multiple interventions," wrote the researchers, led by Dr. Donald Redelmeier of the Sunnybrook Health Science Center in Toronto. Also, the researchers said, patients with chronic diseases may have a shorter life expectancy, so doctors may decide it is not worthwhile to prescribe long-term preventive treatments. In addition, they said, doctors may focus on the most serious disease and forget that the patient may be vulnerable to other illnesses. They said some doctors might be following the scientific principle of looking for the simplest, single explanation for a multitude of symptoms. In an accompanying editorial, Dr. Robert Steinbrook, a deputy editor of the journal, said undertreatment could be even worse in the United States, where drug prices are rising and most patients pay at least part of the cost of each prescription.