Association Between Symptomatic Knee Osteoarthritis and Blood Glucose Control in Persons with Type 2 Diabetes
Bibliographic record
Abstract
Objectives There is a high prevalence of knee osteoarthritis (OA) in people with type 2 diabetes (T2D), and knee OA increases risk for diabetes complications. Our objective was to assess the association between symptomatic knee OA and attainment of target blood glucose levels in individuals with T2D. Methods In this cross-sectional study, we recruited individuals with T2D aged ≥45 years from diabetes clinics at 3 academic hospitals in Toronto. Participants completed standardized online questionnaires that assessed demographics, comorbidities, height and weight, and joint symptoms. From clinic records we abstracted participants’ most recent HbA1c (within 3 months). Knee OA was defined as fulfilling NICE criteria. We considered blood glucose control at target if HbA1c was ≤7.0%. We used multivariable logistic regression to assess the association between knee OA and being at blood glucose target, adjusting for age and gender. We then examined the effect of further adjusting for body mass index (BMI). In secondary analyses, we repeated modeling with exposure of interest knee OA with knee pain ≥20/100 on pain numeric rating scale (NRS) (yes/no). Results We included 351 participants. Mean age was 66.9 (SD 9.8) years, 50.7% women, mean BMI 29.1 (SD 6.8) kg/m 2 , and 28.5% fulfilled NICE criteria for knee OA. Mean HbA1c was 7.4 (SD 1.2); 44% had HbA1c at target (≤7.0%). In univariable analysis, those with knee OA had lower odds of being at target (OR 0.60, 95% CI 0.37 to 0.97). Results were similar after adjusting for age and gender (OR 0.59, 95% CI 0.36 to 0.95). When further adjusting for BMI the effect of knee OA was attenuated and was not statistically significant (OR 0.65, 95% CI 0.39 to 1.06). When exposure of interest was knee OA with self-reported pain ≥20/100, we found a stronger negative association; this met statistical significance even after adjusting for BMI (OR 0.59, 95% CI 0.35 to 0.997) (Figure 1). Figure 1. Effect of (A) knee osteoarthritis overall and (B) knee osteoarthritis with pain ≥20/100 on meeting glyeemic target (HbAlc ≤7.0%). Conclusion Individuals with T2D with knee OA are less likely to be at the recommended target for glycemic control. This association was stronger for those who currently reported pain and remained significant even after adjusting for BMI. This suggests that symptomatic knee OA may increase the risk of diabetes complications through worse glycemic control, and symptom severity is likely important. Further studies are needed to better understand this relationship, as well as the role of additional mechanisms by which knee OA could lead to diabetes complications such as cardiorespiratory fitness and/or systemic inflammation. Best Abstract on Research by Early Career Faculty Award
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".