Association Between Symptomatic Knee Osteoarthritis and Target Glycemic Control in Individuals With Type 2 Diabetes.

Abstract

Knee osteoarthritis (OA) commonly affects individuals with type 2 diabetes (T2DM) and is associated with increased risk of diabetes-related complications. To better understand potential mechanisms, we examined the association between symptomatic knee OA and glycemic control in individuals with T2DM. In this cross-sectional study, we recruited individuals with T2DM aged ≥45 years from three academic centers in Canada. Online questionnaires assessed demographics, medical history, and joint symptoms. We abstracted glycosylated hemoglobin (HbA1c) from clinic records. Knee OA was defined as fulfilling the National Institute of Clinical Excellence criteria. Target glycemic control was defined as an HbA1c level ≤7.0%. Multivariable logistic regression assessed the association between knee OA and target glycemic control, adjusting for age, gender, education level, and body mass index. Secondary analyses assessed associations between knee OA with pain ≥20/100 (and knee OA with walking difficulty) and target glycemic control. Among 351 participants (mean age 66.2 years, 50.7% women), 28.5% met the criteria for knee OA and 43.9% were at glycemic target. In unadjusted analyses, those with knee OA had lower odds of being at target glycemic control (odds ratio [OR] 0.60, 95% confidence interval [CI] 0.37-0.97), but the association was not statistically significant after adjusting for confounders (OR 0.65, 95% CI 0.39-1.08). In those with knee OA with pain ≥20/100, a negative association with target glycemic control was statistically significant in adjusted analysis (OR 0.58, 95% CI 0.34-0.99). Individuals with T2DM and painful knee OA are less likely to be at glycemic target, increasing their risk of diabetes complications.