Knee Osteoarthritis Pain Linked to Poor Blood Sugar Control in Type 2 Diabetes: Study
Canada: Researchers have found in a new study that patients with knee osteoarthritis and type 2 diabetes who experience higher levels of knee pain are significantly less likely—by about 40%—to achieve recommended glycemic control targets. These findings highlight pain as an important barrier to effective diabetes management. Therefore, early diagnosis and management of knee osteoarthritis may help reduce pain, support physical activity, and prevent downstream metabolic consequences.
The study, published in Arthritis Care & Research, was led by Lauren K. King from St. Michael’s Hospital, Toronto, Canada, and colleagues. Knee osteoarthritis and type 2 diabetes commonly coexist in older adults and are both associated with increased disability and cardiometabolic risk. Although osteoarthritis has been linked to poorer diabetes outcomes, the influence of joint pain on glycemic control has not been clearly established.
To address this gap, the researchers conducted a cross-sectional study involving adults aged 45 years and older with type 2 diabetes recruited from three academic centres across Canada. Participants completed online questionnaires capturing demographic information, medical history, and joint symptoms. Knee osteoarthritis was defined using National Institute for Health and Care Excellence (NICE) criteria. Glycemic control was assessed using hemoglobin A1c values extracted from medical records, with an HbA1c level of 7.0% or lower considered to be at target.
The study revealed the following findings:
- The study included 351 participants with a mean age of 66.2 years, and 50.7% were women.
- Overall, 28.5% of participants met criteria for knee osteoarthritis, while 43.9% achieved recommended glycemic control.
- In unadjusted analyses, participants with knee osteoarthritis were less likely to reach glycemic targets than those without osteoarthritis.
- After adjustment for age, sex, education level, and body mass index, the association between knee osteoarthritis and glycemic control was no longer statistically significant.
- When pain severity was considered, a stronger association was observed.
- Participants with knee osteoarthritis and clinically meaningful pain (pain score ≥20/100) had a significantly lower likelihood of achieving glycemic targets.
- Even after adjustment for confounders, painful knee osteoarthritis was associated with nearly 40% lower odds of reaching recommended HbA1c levels.
The findings suggest that pain, rather than the presence of osteoarthritis alone, may play a central role in impaired glycemic control. Knee pain can restrict mobility, reduce physical activity, and interfere with daily self-management behaviors that are critical for diabetes care. Walking difficulty related to osteoarthritis may further exacerbate insulin resistance and metabolic dysregulation.
The authors emphasized the importance of identifying and managing painful knee osteoarthritis in individuals with type 2 diabetes. Integrating musculoskeletal care with diabetes management may help improve glycemic outcomes and reduce the risk of long-term complications. They also noted that longitudinal studies are needed to determine whether effective pain control can lead to sustained improvements in metabolic health.
Reference:
King, L. K., Weisman, A., Shah, B. R., Goldberg, R., Parikh, A., Stanaitis, I., Hung, V., Nisenbaum, R., Almodahka, A., Lipscombe, L., & Hawker, G. A. Association Between Symptomatic Knee Osteoarthritis and Target Glycemic Control in Individuals with Type 2 Diabetes. Arthritis Care & Research. https://doi.org/10.1002/acr.70019
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