Presence of Arthritis in Diabetes

Physical activity is a key component of diabetes mellitus (DM) and arthritis management. DM and arthritis each produce large burdens in the United States; they also share some risk factors including age and obesity. The mechanism of this comorbidity remains uncertain; these co-occurring conditions have been associated with a significant reduction in quality of life and increased risk for other severe complications. In this study, researchers estimate the prevalence of diagnosed arthritis among U.S. adults and the proportion of arthritis-attributable activity limitation (AAAL) among those with arthritis by diagnosed diabetes mellitus (DM) status.

The authors studied the prevalences and their ratios using 2008–2010 U.S. National Health Interview Survey of noninstitutionalized U.S. adults aged ≥18 years. Respondents’ arthritis and DM status were both based on whether they reported a diagnosis of these diseases. Other characteristics used for stratification or adjustment included age, sex, race/ethnicity, education level, BMI, and physical activity level. The final analytic sample included 76,542 adults; of those 3,124 adults had missing values for height, weight, or physical activity level. There was no statistically significant difference for demographic characteristics between adults with and without missing values on DM, arthritis, or AAAL. However, adults with missing values for height, weight, or physical activity level were more likely to be women, adults with diagnosed DM and arthritis, and older than adults without any missing values on those variables (all P values, 0.05).

Among adults with DM, the unadjusted prevalences of arthritis and proportion of AAAL among adults with arthritis were 48.1% (9.6 million) and 55.0% (5.3 million), respectively. After adjusting for other characteristics, the prevalence ratios of arthritis and of AAAL among arthritic adults with versus without DM (95% CI) were 1.44 (1.35–1.52) and 1.21 (1.15–1.28), respectively. The prevalence of arthritis increased with age and BMI and was higher for women, non-Hispanic whites, and inactive adults compared with their counterparts both among adults with and without DM (all P values, 0.05). Based on these findings, the authors conclude that among U.S. adults with diagnosed DM, nearly half also have diagnosed arthritis; moreover, more than half of those with both diseases had AAAL. Arthritis can be a barrier to physical activity among adults with diagnosed DM.

Practice Pearls:

• Arthritis can be a barrier to physical activity among adults with diagnosed DM.
• Among U.S. adults with diagnosed DM, nearly half also have diagnosed arthritis.
• More than half of those with both diseases had arthritis-attributable activity limitation.

Diabetes Care, August 2012