Patients with osteoarthritis (OA) and diabetes mellitus (DM) experience greater knee pain and worse physical and mental status compared with patients without DM, according to study results published in Arthritis Care & Research.

To assess the effect of DM on OA pain sensation and physical and mental health, researchers used data from the public Osteoarthritis Initiative database and identified 202 individuals with OA and DM and 2279 with OA who did not have DM.

Each patient completed the 5 domains of Knee injury and Osteoarthritis Outcome Score (KOOS), with assessment of knee pain using the KOOS-pain subscale. An 11-point numerical rating scale was used to assess specific pain severity score in the prior 30 days and the Physical Activity Scale for the Elderly was used to estimate physical activity level. The Medical Outcomes Study Short Form 12 (SF-12) was used to assess general health status, including physical and mental function. The Center for Epidemiological Studies-Depression Scale (CES-D) was used to assess depressive symptoms.

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There was a statistically significant association between the presence of DM and worse knee pain according to the KOOS-pain (β=-4.72; 95% CI, -7.22 to -2.23; P <.001) and numerical rating scale for pain scores (β=0.42; 95% CI, 0.04-0.80; P =.31), independent of body mass index, OA severity, age, and sex.

Furthermore, there was a strong and statistically significant association between the presence of DM and OA and worse physical function according to SF-12 physical function score (β=-3.49; 95% CI, -4.73 to -2.25; P <.001) after adjusting for age and sex, but not according to the Physical Activity Scale for the Elderly. In a similar fashion, mental parameters, according to the SF-12 mental function score (β=-1.42; 95% CI, -2.57 to -0.26; P =.016), were worse in patients with DM.

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Significant depressive symptoms (CES-D score ≥16) were evident in 14.4% of patients with DM compared with 9.1% of patients without DM (CES-D: β=1.08; 95% CI, 0.08-2.08; P =.035).

The cross-sectional analysis had several limitations, including missing data on DM disease history and blood-serum analyses and potential additional unmeasured confounders.

“Given greater pain and worse physical and mental health status compared with non-DM OA patients at the same radiographic disease stage, knee OA patients with DM require particular attention in preventing and managing knee osteoarthritis,” concluded the researchers.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Eitner A, Culvenor AG, Wirth W, Schaible HG, Eckstein F. Impact of diabetes mellitus on knee osteoarthritis pain and physical and mental status: data from the Osteoarthritis Initiative [published online February 27, 2020]. Arthritis Care Res (Hoboken). doi:10.1002/acr.24173