Abstract
Objective: Type 2 diabetes (T2D) has been associated with osteoarthritis (OA). However, research related to the impact of T2D on pain severity is limited. The purpose of this study was to examine the association between T2D and pain severity in people with localized OA (LOA) (e.g., OA restricted to only one or two joints), and to explore the association between glycosylated hemoglobin (A1c) level and pain severity in people with LOA and T2D.
Methods: A retrospective review of data from a tertiary medical center was performed. Records were selected based on diagnoses codes for LOA using international classification of disease 9th and 10threvisions. Index date was set as the first diagnosis date. Pain severity, measured by a 0 to 10 numeric rating scale, was obtained and linked to the index date. T2D was defined as having two diagnostic codes for T2D or using insulin. A1c was obtained for patients with T2D within six months of the index date. Covariates of age, sex, depression, hypertension, dyslipidemia, and medications (+/- 90 days of the index date) were included in linear regression analysis. Alpha level was 0.05.
Results: Data from 819 patients (mean age = 65.08±9.77, 54.3% women) included 671 patients with LOA only (n=671) and 148 patients with LOA+T2D. T2D was significantly associated with increased pain severity (B=1.08, 95% CI 0.23 -1.93, p=0.013) after controlling for covariates. For patients with LOA+T2D with data for A1C (n=87), higher A1c was significantly associated with increased pain severity (B=0.33, 95% CI 0.01 -0.64, p=0.045) after controlling for medications.
Conclusion: This study found that T2D was associated with higher pain severity in people with LOA, and that poorer glycemic control was associated with higher pain severity in people with LOA+T2D. Only T2D was associated with pain that exceeded the clinically meaningful difference (>1 score). Clinicians should consider T2D as a factor in the management of pain in people with LOA.
Disclosure
A.M. Alenazi: None. S.M. Obaidat: None. M. Alshehri: None. C.M. Gray: None. S. Alothman: None. J.L. Rucker: None. L.R. Waitman: None. P. Kluding: None.