Department of Medicine, University of Toronto, Toronto, Ontario, Canada
Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
BMJ Open. 2022 Nov 4;12(11):e061472. doi: 10.1136/bmjopen-2022-061472.
Type 2 diabetes (T2DM) and knee osteoarthritis (OA) commonly co-occur and epidemiologic studies suggest concomitant symptomatic knee OA increases the risk of T2DM complications. We sought to explore the experiences and perspectives of individuals' living with both symptomatic knee OA and T2DM, with a focus on the impact of OA on T2DM management and daily life.
We conducted qualitative semistructured telephone interviews with persons living with T2DM and knee OA. We inductively coded and analysed interview transcripts, informed by interpretative description.
We recruited participants from a community arthritis self-management programme and an academic hospital's family medicine clinic in Ontario, Canada.
We included 18 participants who had a physician diagnosis of both T2DM and knee OA, with variation age, gender, and duration of T2DM and knee OA.
Participants with T2DM described how concomitant painful and disabling knee OA made it difficult to engage in physical activity, negatively impacting blood glucose control. Joint pain itself, associated sleep disturbance and emotional distress were also seen to affect blood glucose control. Beyond diabetes management, the impact of OA-related pain and functional limitations on nearly all aspects of daily life led participants to view their OA as important. Despite this, many participants described that their health professionals paid little attention to their OA, which left them to self-manage. Balancing both conditions also required navigating a medical system that provided piecemeal care.
Individuals with T2DM view symptomatic knee OA as an important barrier to both T2DM management and overall well-being, yet are frequently met with insufficient support from health professionals. Greater recognition and management of knee OA in persons with T2DM could help improve patient-centred care and potentially disease outcomes.
2 型糖尿病（T2DM）和膝骨关节炎（OA）常同时发生，流行病学研究表明，同时存在有症状的膝 OA 会增加 T2DM 并发症的风险。我们试图探讨同时患有有症状的膝骨关节炎和 T2DM 的个体的经历和观点，重点关注 OA 对 T2DM 管理和日常生活的影响。
我们对患有 T2DM 和膝骨关节炎的患者进行了定性半结构式电话访谈。我们根据解释性描述，对访谈记录进行了归纳编码和分析。
我们在加拿大安大略省的一个社区关节炎自我管理计划和一家学术医院的家庭医学诊所招募参与者。
我们纳入了 18 名参与者，他们都有医生诊断为 T2DM 和膝骨关节炎，年龄、性别和 T2DM 及膝骨关节炎的持续时间各不相同。
患有 T2DM 的参与者描述了同时患有疼痛和使活动受限的膝骨关节炎如何使他们难以进行身体活动，从而对血糖控制产生负面影响。关节疼痛本身、相关的睡眠障碍和情绪困扰也被认为会影响血糖控制。除了糖尿病管理之外，OA 相关的疼痛和功能限制对日常生活的几乎所有方面都有影响，这使得参与者认为 OA 很重要。尽管如此，许多参与者表示，他们的健康专业人员对他们的 OA 关注甚少，这使得他们只能自我管理。平衡这两种疾病还需要在提供零碎护理的医疗系统中进行导航。
患有 T2DM 的个体将有症状的膝骨关节炎视为 T2DM 管理和整体健康的重要障碍，但他们经常得不到健康专业人员的充分支持。在患有 T2DM 的人群中，对膝骨关节炎的更多认识和管理可能有助于改善以患者为中心的护理，并可能改善疾病结局。
