Chronic Pain Hampers Diabetes Self-Care
Harder to Exercise, Diet, and Take Meds With Chronic Pain
Chronic Pain Common
Jan. 14, 2005 -- Treating pain may be a key factor in helping to get under control.
diabetes, making it harder for them to
manage their condition through , , and , a study shows.
hounds many people with
Sarah Krein, PhD, RN, and colleagues report the findings in the January
issue of Diabetes Care. Krein works at Veterans Affairs (VA) Ann Arbor
Healthcare System in Michigan.
The burden of living in pain could distract diabetes patients from doing
what's necessary for their health, say the researchers. "Chronic pain may
be a major limiting factor in the performance of certain self-care
behaviors," they say, calling for self-care plans that take pain and other
chronic conditions into account.
Nearly 1,000 diabetes patients participated in the study. Most were men in
On a scale of 1-5, the participants rated how hard it was for them to take
diabetes medications, exercise regularly, follow their recommended eating plan,
check their blood sugar level, and examine their feet for wounds and sores.
Besides those benchmarks of diabetes self-care, the surveys also screened
for depression and asked the participants to rate their overall health.
Chronic Pain Common
About 60% of participants reported chronic pain, which was described as pain
that was present most of the time for six or more months during the past year.
, hip, and knee were most
On average, patients said pain had disrupted their daily life for 18 out of
the last 28 days. Pain medications were taken regularly or occasionally by 78%.
Those with chronic pain tended to be younger, heavier, female, and insulin
Self-care suffered with chronic pain. Participants with chronic pain had
more trouble exercising and following their recommended diets. However, they
didn't have problems taking their medications or checking their feet for wounds
General health ratings were also lower for chronic pain participants. More
than half said they were in fair or poor health, compared with about a third of
those without chronic pain.
In addition, chronic pain was often accompanied by
. Nearly half of the
participants with chronic pain showed signs of depression. In contrast, only
20% of pain-free participants had depression symptoms.
Even after depression and other factors were considered, the link between
pain and self-care still held. Taking pain medications helped, but not enough
to match the level of self-care seen in pain-free participants.
Severe Pain Makes Self-Care Tougher
Almost a third of participants with chronic pain said their pain was severe
or very severe during the past four weeks. They did a significantly poorer job
of managing their diabetes than those with mild or moderate pain.
For instance, participants with severe chronic pain found it tough to take
their diabetes medications, which wasn't a problem for people with milder pain.
Exercise was also harder with severe pain.