Osteoarthritis-related difficulty walking and risk for diabetes complications
Hawker GA , Croxford R, Bierman AS, Harvey P, Ravi B, Kendzerska T, Stanaitis I, King LK, Lipscombe L. Osteoarthritis Cartilage. 2017; 25(1):67-75. Epub 2016 Aug 15.
Objectives — To examine the effect of 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 (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.
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