Gender differences in the effect of diabetes mellitus and its treatment on osteoarthritic pain.
Objective
(1) To investigate differences in pain severity and its distribution between patients with and without diabetes mellitus (DM) in a population with advanced osteoarthritis (OA). (2) To explore the role of medication used for diabetes in these associations.


Research design and methods
This is a hospital-based cohort study of patients with advanced OA requiring total joint arthroplasty. Interviews and electronic records included: age, gender, occupation, DM (including medication and duration), analgesics used, anthropometry, joints affected by pain and disease duration. Joint pain was scored by the patients using numerical rating scale. Pain severity score was calculated by adding the number of joints affected by pain and the maximum pain score. All analyses were adjusted and/or stratified by gender, age and body mass index.


Results
In total, 489 patients with painful OA were included. From those, 139 patients had DM (30% males and 28% females, p=0.03). Pain severity, principally the number of joints affected by pain, and analgesic consumption, was higher in males with diabetes compared with males without diabetes (p=0.012 and OR=3.03; 95% CI 1.24 to 7.36, p=0.015, respectively). These associations were not significant in females (p=0.41 and p=0.66). Pain was more severe in males using insulin versus those who did not (p=0.025). Male subjects with diabetes had higher odds of hand pain or knee and hand pain compared with males without diabetes (OR=3.7, 95% CI 1.15 to 12; p=0.028 and OR=5.54; 95% CI 1.43 to 21.5, p=0.013, respectively).


Conclusions
Males with diabetes, especially those who require insulin, have more severe joint pain and consume more analgesics than males without diabetes or those who have DM and use other DM medication.
['Castano Betancourt|Martha Cecilia|MC|0000-0002-6340-0146', 'Morais|Carolina Larissa|CL|', 'Vannucci Nunes Lipay|Monica|M|', 'Aragão|Jordani|J|', 'de Azevedo E Souza Munhoz|Marcelo|M|', 'Gomes Machado|Eduardo|E|', 'Marchi|Evaldo|E|']
D000368:Aged D018771:Arthralgia D015331:Cohort Studies D003924:Diabetes Mellitus, Type 2 D005260:Female D006621:Hip Joint D006801:Humans D007004:Hypoglycemic Agents D007719:Knee Joint D008297:Male D008875:Middle Aged D020370:Osteoarthritis, Knee D010147:Pain Measurement D012307:Risk Factors D012720:Severity of Illness Index D012727:Sex Characteristics D012737:Sex Factors
pain adult diabetes rheumatologic/musculoskeletal disease risk factors