Highlights
- •Half of the patients with type 2 diabetes mellitus suffered from chronic musculoskeletal pain in primary care.
- •The pain intensity was of mild degree and not associated with diabetes self-management.
- •Chronic pain and its severity were associated with poor quality of life in DM patients.
- •Depression was associated with poorer diabetic self-care and quality of life in DM patients.
Abstract
Aims
To examine the prevalence of chronic musculoskeletal (MSK) pain and its association
with diabetes self-management, glycemic control and health-related quality of life
(HRQoL) in patients with diabetes mellitus (DM) in primary care.
Methods
329 patients with type 2 DM were recruited at public primary care clinics in Hong
Kong. Chronic MSK pain was defined as having MSK pain ≥ 3 months, and the pain severity
was measured by Brief Pain Inventory (BPI). Diabetes Management Self-Efficacy Scale
(DMSES), hemoglobin A1c (HbA1c) and EuroQuol-5D (EQ5D) were collected. Multivariable
regression was used to examine the association between the presence of chronic MSK
pain with DMSES, HbA1c and EQ5D, adjusted for baseline confounders such as age, sex,
BMI, duration of DM and comorbid depression.
Results
Approximately 49.5% of respondents reported chronic MSK pain with a median BPI severity
score of 3.5 (2.0–5.0). The presence of chronic MSK pain was associated with lower
HRQoL (β = −0.053, 95% CI −0.087 to −0.018, P = 0.003), but was not associated with
the diabetes self-management and glycemic control. Depression was associated with
poorer diabetes self-management (β = −2.776, 95% CI −4.247 to −1.304, P < 0.001) and
HRQoL.( β = −0.018,95% CI-0.025 to −0.012, P < 0.001).
Conclusions
Chronic MSK pain was present in nearly half of the diabetic patients in primary care;
however, the degree of pain was mild and had not shown to affect diabetes self-management
and glycemic control. Depression was associated with poorer diabetes self-management.
Chronic MSK pain and depression were both associated with poorer HRQoL.
Abbreviations:
AAPCG (Asia-Pacific Academic Primary Care Group), BMI (Body mass index), BPI (Brief Pain Inventory), CI (Confidence interval), DMSES (Diabetes Management Self-Efficacy Scale), EQ5D (EuroQuol-5D), GAD-7 (General Anxiety Disorder), HbA1c (Hemoglobin A1c), HRQoL (Health-related quality of life), ICD-11 (International Classification of Disease-11), MSK (Musculoskeletal), PHQ-9 (Patient Health Questionnaire)Keywords
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Article info
Publication history
Published online: April 26, 2022
Accepted:
April 20,
2022
Received in revised form:
April 19,
2022
Received:
January 11,
2022
Identification
Copyright
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
