Research Article 
Prevalence of pain and association with quality of life, depression and glycaemic control in patients with diabetes
M. J. Bair, J. Bair, R. T. Ackermann, C. Shen, K. Kroenke and D. G. Marrero
Diabetic Medicine, 2010, 27(5), 578-584. DOI: 10.1111/j.1464-5491.2010.02971.x
Abstract
Aims 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 (HbA1c) 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/m2, 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 HbA1c than those without pain (8.3 vs. 8.0%, P = 0.001). In multivariable analyses, pain was not associated with HbA1c (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.
ASCI-ID: 109-717
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Development and evaluation of a standardized registry for diabetes in pregnancy using data from the Northern, North West and East Anglia regional auditsDiabetic Medicine, 2011, 28(7), 797-804. DOI: 10.1111/j.1464-5491.2011.03259.x
Mobile phone support is associated with reduced ketoacidosis in young adultsDiabetic Medicine, 2011, 28(8), 1001-1004. DOI: 10.1111/j.1464-5491.2011.03302.x
Lower cardiorespiratory fitness in children with Type 1 diabetesDiabetic Medicine, 2011, 28(8), 1005-1007. DOI: 10.1111/j.1464-5491.2011.03271.x
Illness perceptions and glycaemic control in diabetes: a systematic review with meta-analysisDiabetic Medicine, 2011, 28(11), 1300-1310. DOI: 10.1111/j.1464-5491.2011.03298.x
Acute hepatic injury following treatment of a long-acting insulin analogue overdose necessitating urgent insulin depot excisionDiabetic Medicine, 2012, 29(2), 232-235. DOI: 10.1111/j.1464-5491.2011.03385.x
Effects of variations in duodenal glucose load on glycaemic, insulin, and incretin responses in type 2 diabetesDiabetic Medicine, 2012, 29(5), 604-608. DOI: 10.1111/j.1464-5491.2011.03496.x
Glycaemic control and weight 7 years after Dose Adjustment For Normal Eating (DAFNE) structured education in Type 1 diabetesDiabetic Medicine, 2012, 29(6), 807-812. DOI: 10.1111/j.1464-5491.2011.03525.x
Small-fibre involvement in diabetic patients with neuropathic foot painDiabetic Medicine, 2008, 25(6), 692-699. DOI: 10.1111/j.1464-5491.2008.02446.x
Amitriptyline vs. pregabalin in painful diabetic neuropathy: a randomized double blind clinical trialDiabetic Medicine, 2009, 26(10), 1019-1026. DOI: 10.1111/j.1464-5491.2009.02806.x
Exercise treadmill testing in patients with claudication, with and without diabetesDiabetic Medicine, 2011, 28(3), 356-362. DOI: 10.1111/j.1464-5491.2010.03208.x
Randomized trial of custom orthoses and footwear on foot pain and plantar pressure in diabetic peripheral arterial diseaseDiabetic Medicine, 2009, 26(9), 893-899. DOI: 10.1111/j.1464-5491.2009.02799.x
Systematic literature review: quality of life associated with insulin pump use in Type 1 diabetesDiabetic Medicine, 2007, 24(6), 607-617. DOI: 10.1111/j.1464-5491.2007.02120.x
Health utility values associated with diabetic retinopathyDiabetic Medicine, 2008, 25(5), 618-624. DOI: 10.1111/j.1464-5491.2008.02430.x
Investigation of quality of life and family burden issues during insulin pump therapy in children with Type 1 diabetes mellitus—a large-scale multicentre pilot study1Diabetic Medicine, 2009, 26(5), 493-501. DOI: 10.1111/j.1464-5491.2009.02707.x
Patient-reported outcomes following islet cell or pancreas transplantation (alone or after kidney) in Type 1 diabetes: a systematic reviewDiabetic Medicine, 2010, 27(7), 812-822. DOI: 10.1111/j.1464-5491.2010.03029.x
Initiation of insulin glargine in patients with Type 2 diabetes in suboptimal glycaemic control positively impacts health-related quality of life. A prospective cohort study in primary careDiabetic Medicine, 2011, 28(9), 1096-1102. DOI: 10.1111/j.1464-5491.2011.03329.x
Quality of life and treatment satisfaction in adults with Type 1 diabetes: a comparison between continuous subcutaneous insulin infusion and multiple daily injectionsDiabetic Medicine, 2008, 25(2), 213-220. DOI: 10.1111/j.1464-5491.2007.02346.x
Quality of life in children with Type 1 diabetes: a comparison of general and diabetes-specific measures and support for a unitary diabetes quality-of-life constructDiabetic Medicine, 2008, 25(11), 1316-1323. DOI: 10.1111/j.1464-5491.2008.02574.x
Not all roads lead to Rome-a review of quality of life measurement in adults with diabetesDiabetic Medicine, 2009, 26(4), 315-327. DOI: 10.1111/j.1464-5491.2009.02682.x
Randomized trial of custom orthoses and footwear on foot pain and plantar pressure in diabetic peripheral arterial diseaseDiabetic Medicine, 2009, 26(9), 893-899. DOI: 10.1111/j.1464-5491.2009.02799.x
People living with diabetes resident in nursing homes-assessing levels of disability and nursing needsDiabetic Medicine, 2011, 28(7), 778-780. DOI: 10.1111/j.1464-5491.2011.03261.x
The impact of hypoglycaemia on quality of life and related patient-reported outcomes in Type 2 diabetes: a narrative reviewDiabetic Medicine, 2012, 29(3), 293-302. DOI: 10.1111/j.1464-5491.2011.03416.x
Psychological status of Chinese patients with Type 2 diabetes: data review of Diabcare-China studiesDiabetic Medicine, 2012, 29(4), 515-521. DOI: 10.1111/j.1464-5491.2011.03436.x
Improved health status with insulin degludec compared with insulin glargine in people with Type 1 diabetesDiabetic Medicine, 2012, 29(6), 716-720. DOI: 10.1111/j.1464-5491.2011.03547.x