Association of pain with HbA_1c in a predominantly black population of community‐dwelling adults with diabetes: a cross‐sectional analysis

Abstract

Aims To assess the relationship between pain and HbA1c levels in a predominantly black population with diabetes, and to determine whether self-management behaviours (exercise and diet) and symptoms of depression mediate this relationship. Methods We analysed cross-sectional data from 417 community-dwelling individuals with diabetes in rural Alabama, USA. Binary logistic regression was used to analyse the relationship between pain and HbA1c levels, defined as relatively good [≤ 64 mmol/mol (≤ 8.0%)] and relatively poor [> 64 mmol/mol (> 8.0%)], after adjusting for sociodemographics, insulin use, medication count, cigarette smoking history and body mass index (BMI). We examined the mediating roles of exercise, diet, and symptoms of depression using bootstrapping. Results Participants were primarily black (86.6%), female (76.1%) and reported an annual income of ≤$20,000 (52.7%). Their mean (SD) age was 59.6 (12.8) years. The majority of the participants reported moderate to extreme pain (71.5%). Participants reporting pain were more than twice as likely to have HbA1c levels > 64 mmol/mol (8.0%) in the fully adjusted model (odds ratio 2.33 [95% CI 1.28–4.24]; P < 0.05). Diet significantly mediated the relationship between pain and HbA1c control (β = 0.06; 95% CI: 0.01–0.17), but only in the unadjusted model. Exercise and symptoms of depression were not significant mediators. Conclusions A significant independent relationship between pain and HbA1c control was found in this mainly black population, which was not explained by self-management behaviours or symptoms of depression. Future research is needed to delineate the mechanism by which pain influences HbA1c control, especially among black people with diabetes on low incomes.

Cough in the Elderly Population: Relationships with Multiple Comorbidity

“…Our relationships with high HbA1C levels further suggest diabetes mellitus, especially uncontrolled, needs to be considered as a potential risk factor for cough, particularly in the elderly population. There is still a paucity of studies investigating the associations between HbA1c and non-diabetic, or non-cardiovascular conditions; however, high HbA1c was positively related to reflux symptom episodes in adolescents [34], and also was independently associated with the increased prevalence of pain [35,36]. …”

Association between Chronic Pain and Diabetes/Prediabetes: A Population-Based Cross-Sectional Survey in Saudi Arabia

“…Studies conducted in Finland showed that higher glucose levels in plasma and diabetes both were associated with daily chronic pain in adults [16,17]. Similarly, another study conducted among the black population of the USA showed significant and independent relationship between pain and HbA1c (>64 mmol/mol), suggesting greater pain with poor HbA1c control [18]. A recent study showed a genetic predisposition between diabetes and lower back pain [19].…”

Diabetes Is Associated with Musculoskeletal Pain, Osteoarthritis, Osteoporosis, and Rheumatoid Arthritis

“…The study found that pain was associated with higher BMI, reduced quality of life, low physical function, and the ability to be physically active. Other studies have also reported that diabetes is associated with an increased risk of having musculoskeletal pain [4, 5].…”