Impact of Diabetes Mellitus on Knee Osteoarthritis Pain and Physical and Mental Status: Data From the Osteoarthritis Initiative

Abstract

Objective Diabetes mellitus (DM) appears to increase osteoarthritic knee pain, which may be related to greater adiposity and more advanced disease status often observed in individuals with osteoarthritis (OA) and DM. We aimed to assess whether OA knee pain and health status are worse in individuals with OA and DM, independent of these potential confounders. Methods We included 202 OA participants with DM and 2,279 without DM from the Osteoarthritis Initiative. Knee pain was evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and a numeric rating scale (NRS). Physical and mental status were assessed by the Medical Outcomes Study Short Form 12 (SF‐12) questionnaire, physical component summary (PCS) score and mental component summary (MCS) score, and by the Center for Epidemiologic Studies Depression Scale (CES‐D). Linear regression models assessed the influence of DM, adjusted for age, sex, body mass index (BMI), and radiographic severity. Results OA participants with DM reported worse knee pain and greater physical and mental issues compared with participants without DM. Individuals with DM had worse KOOS pain (β = –4.72 [95% confidence interval (95% CI) –7.22, –2.23]) and worse NRS pain (β = 0.42 [95% CI 0.04, 0.80]) independent of BMI, OA severity, age, and sex. The negative influence of DM was also apparent for SF‐12 PCS (β = –3.49 [95% CI –4.73, –2.25]), SF‐12 MCS (β = –1.42 [95% CI –2.57, –0.26]), and CES‐D (β = 1.08 [95% CI 0.08, 2.08]). Conclusion Individuals with knee OA experience on average higher pain intensity and a worse physical and mental health status if they have DM. Linear regression models show that DM is a risk factor for higher pain, in addition to and independent of greater BMI and radiographic OA severity.

Gait Speed as a Predictor for Diabetes Incidence in People with or at Risk of Knee Osteoarthritis: A Longitudinal Analysis from the Osteoarthritis Initiative

“…Furthermore, this study did not include people with or at risk of knee OA. People with OA and DM are at a greater risk of metabolic syndromes and functional limitations such as higher pain and slower gait speed [ 21 , 24 , 31 , 32 , 33 , 34 , 35 ] requiring early intervention. Therefore, it is essential to examine the prognostic utility for gait speed in predicting incident DM, and its associated cutoff value.…”

The subjective knee value is a valid single-item survey to assess knee function in common knee disorders

“…stated as not applicable) were primarily reported on activity-related subscales. Furthermore, low scores may not stringently indicate poor knee function but rather be due to general poor health or other illness [43][44][45]. In the current study, a group of patients with knee osteoarthritis mentioned severe problems while running caused by chronic obstructive pulmonary disease or cardiac issues rather than the knee joint itself.…”

Decrease in Opioid and Intra-Articular Corticosteroid Burden After Intra-Articular Hyaluronic Acid for Knee Osteoarthritis Treatment

“…However, the potential confounders may be evened out with the large patient population in both cohorts (HA: 128,658; KA: 83,496). Others have also described the association between diabetes and pain severity in those with localized OA [24], as well as with knee pain in those with knee OA [25,26].…”