Background/Purpose: The links between osteoarthritis (OA) and other common chronic conditions, such as type 2 diabetes mellitus (T2DM), are increasingly being appreciated in epidemiological studies. However, patient perceptions of the impact of concomitant knee OA on their ability to engage in chronic disease management remains unknown. Using qualitative methods, we sought to explore individuals’ experiences living with knee OA and T2DM, with a focus on the impact of OA on T2DM management and daily life.

Methods: Semi-structured telephone interviews were conducted with persons with symptomatic knee OA and T2DM recruited from a hospital-based diabetes clinic and a community OA program (Arthritis Society) in Ontario, Canada. The methodology of qualitative description was used. Interview transcripts were coded by a team of researchers and data were analysed using thematic analysis to identify major themes. Interviewing stopped after no new themes or subthemes were identified.

Results: Eighteen participants were interviewed: n=9 women, n=9 aged ≥70 years, n=8 urban region, n=9 ≥10 years since diabetes diagnosis, and n=13 ≥10 years since OA diagnosis. Three overarching themes were constructed: 1. OA impacts diabetes control: Painful and disabling OA made it difficult for participants to engage in physical activity prescribed for T2DM, and they perceived that lack of physical activity negatively impacted their blood sugar control. Joint pain, and its effect on sleep and emotional health, were also seen to negatively impact blood sugar control. 2. OA as a health priority due to its effects on quality of life: Participants, who often had other chronic conditions in addition to T2DM, viewed OA as a health priority. OA-related pain and functional limitations reduced ability to participate in valued activities, e.g., work, and negatively impacted emotional well-being. 3. Minimization of OA by health professionals and taking personal responsibility for OA care: Participants perceived a disproportionately greater attention by health professionals to their T2DM compared to their OA. As a result, many participants described being left to coordinate and advocate for their own OA care.

Conclusion: These findings shed light on patients’ experiences of living with symptomatic knee OA in the context of T2DM. OA-related pain, functional limitations, poor sleep and mental health were perceived as negatively impacting diabetes control and engagement in daily life activities. While considered important to patients, often these concerns were not being actively addressed by health professionals. Greater recognition by health professionals of the impact of knee OA in persons with T2DM has potential to improve both diabetes care and overall quality of life.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/its-a-dance-between-managing-both-diabetes-and-osteoarthritis-a-qualitative-study-exploring-perspectives-of-persons-with-knee-osteoarthritis-and-type-2-diabetes-mellitus/