Osteoarthritis-related difficulty walking and risk for diabetes complications. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Hawker, G.A.; Croxford, R.; Bierman, A.S.; Harvey, P.; Ravi, B.; Kendzerska, T.; Stanaitis, I.; King, L.K.; Lipscombe, L.
• Is Part Of: Osteoarthritis and cartilage. Volume 25:Issue 1(2017)
• Page Start: 67
• Page End: 75
• Publication Date: 2017-01
• Subjects: Osteoarthritis -- Walking disability -- Chronic conditions -- Diabetes -- Comorbidity; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Arthrose -- Périodiques; Articulations -- Maladies -- Périodiques; 616.7223005
• DOI: 10.1016/j.joca.2016.08.003
• Languages: English
• ISSNs: 1063-4584

Abstract

Summary: Objectives: To examine the effect of Osteoarthritis (OA)-related difficulty walking on risk for diabetes complications in persons with diabetes and OA. Design: A population cohort aged 55+ years with symptomatic hip and knee OA was recruited 1996–98 and followed through provincial administrative data to 2015 ( n = 2, 225). In those with confirmed OA (examination and radiographs) and self-reported diabetes at baseline ( n = 359), multivariate Cox regression modeling was used to examine the relationship between baseline difficulty walking (Health Assessment Questionnaire (HAQ) difficulty walking score; use of walking aid) and time to first diabetes-specific complication (hospitalization for hypo- or hyperglycemia, infection, amputation, retinopathy, or initiation of chronic renal dialysis) and cardiovascular (CV) events. Results: Participants' mean baseline age was 71.4 years; 66.9% were female, 77.7% had hypertension, 54.0% had pre-existing CV disease, 42.9% were obese and 15.3% were smokers. Median HAQ difficulty walking score was 2/3 indicating moderate to severe walking disability; 54.9% used a walking aid. Over a median 6.1 years, 184 (51.3%) experienced one or more diabetes-specific complications; 191 (53.2%) experienced a CV event over a median 5.7 years. Greater baseline difficulty walking was associated with shorter time to the first diabetes-specific complication (adjusted HR per unit increase in HAQ walking 1.24, 95% CI 1.04–1.47, P = 0.02) and CV event (adjusted HR for those using a walking aid 1.35, 95% CI 1.00–1.83, P = 0.04). Conclusions: In a population cohort with OA and diabetes, OA-related difficulty walking was a significant – and potentially modifiable – risk factor for diabetes complications.