Prevalence of pain and association with quality of life, depression and glycaemic control in patients with diabetes.
OBJECTIVE
To determine the prevalence of pain and its association with glycaemic control, mental health and physical functioning in patients with diabetes.


METHODS
Cross-sectional data from a multi-site, prospective cohort study of 11 689 participants with diabetes. We analysed the associations of pain severity and interference with glycated haemoglobin (HbA(1c)) measurements and Medical Outcomes Study SF-Mental and Physical Component Summary-12 (MCS-12 and PCS-12) scores.


RESULTS
Of participants, 57.8% reported moderate to extreme pain and, compared with those without pain, were somewhat older (60.8 vs. 59.9 years, P < 0.001), more obese (body mass index of 32.1 vs. 29.8 kg/m(2), P < 0.001), more likely to report being depressed or anxious (41.3 vs. 16.2%, P < 0.001) and more likely to report fair or poor health (48.5 vs. 23.1%, P < 0.001). Bivariate comparisons demonstrated that patients with extreme pain had higher HbA(1c) than those without pain (8.3 vs. 8.0%, P = 0.001). In multivariable analyses, pain was not associated with HbA(1c) (P = 0.304) but was strongly associated with worse MCS-12 (P < 0.001), PCS-12 (P < 0.001) and depression (P < 0.001). Depression was 1.3 (95% CI: 1.12, 1.96) times more likely in patients with moderate pain and 2.0 (95% CI: 1.56, 2.46) times more likely in patients with extreme pain.


CONCLUSIONS
Moderate to extreme pain was present in 57.8% of diabetic patients. Pain was strongly associated with poorer mental health and physical functioning, but not worse glycaemic control. Recognizing the high prevalence of pain and its strong association with poorer health-related quality of life may be important to improve the comprehensive management of diabetes.
Roudebush VA Center of Excellence on Implementing Evidence-Based Practice, Indianapolis, IN 46202, USA. mbair@iupui.edu
M J
MJ
Bair
E J
EJ
Brizendine
R T
RT
Ackermann
C
C
Shen
K
K
Kroenke
D G
DG
Marrero
D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000097:blood* / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life
D006442:Glycated Hemoglobin