The major burden of knee joint osteoarthritis (OA) is pain. Since in elder patients diabetes mellitus is an important comorbidity of OA, researchers of the University Hospital of Jena, Germany, have explored whether the presence of diabetes mellitus has a significant influence on pain intensity at the end stage of knee OA, and we aimed to identify factors possibly related to changes of pain intensity in diabetic patients.
In 23 diabetic and 47 non-diabetic OA patients undergoing total knee arthroplasty, we assessed the pain intensity before the operation using the “Knee injury and Osteoarthritis Outcome score” (KOOS) and analyzed other parameters in the patient’s serum.
Diabetic patients had on average a higher KOOS pain score than non-diabetic patients and knee joints from diabetic patients exhibited a greater concentration of inflammatory molecules. These data suggest that diabetes mellitus significantly increases pain intensity of knee OA, and that in diabetic patients higher pain intensities were determined by stronger synovitis.
Osteoarthritis and comorbidities
The term comorbidity is used to talk about the presence of two or more diseases at once and the effect this may have for the patient who suffers them. In the case of osteoarthritis, comorbidities are a determining factor for medical follow-up. Fifty percent of patients with knee or hip osteoarthritis suffer other diseases such as hypertension, lung or heart disease, and diabetes.
Most of these patients are polymedicated. Therefore, each patient of osteoarthritis should be treated by his physician taking into account his risk factors and his comorbidities.
Eitner A, Pester J, Vogel F, Marintschev I, Lehmann T, Hofmann GO, Schaible HG. Pain sensation in human osteoarthritic knee joints is strongly enhanced by diabetes mellitus. Pain. 2017 Jun 8. doi: 10.1097/j.pain.0000000000000972. [Epub ahead of print]