Daily sitting time may be associated with knee pain in adults with type 2 diabetes mellitus

1. In this cross-sectional study, increased daily sitting time was significantly associated with higher odds of knee pain, but not neck, shoulder, or lower back pain, in patients with type 2 diabetes mellitus (T2DM).

2. However, there was no significant association between sitting time and musculoskeletal pain (MSP) in patients with prediabetes or normal glucose metabolism.

Evidence Rating Level: 2 (Good)

Patients with type 2 diabetes mellitus (T2DM) may experience musculoskeletal pain (MSP) as a comorbidity of their illness. Although there have been associations between increases in MSP with higher volumes of sitting in some cohort studies, this association has not been extensively studied in patients with T2DM. As a result, the objective of the present study was to investigate the role of daily sitting time on MSP in middle-aged and older adult patients with T2DM, compared to those with prediabetes and normal glucose metabolism.

In this cross-sectional study, 2827 (n=658 with T2DM) participants from The Maastricht Study were included. Participants from the initial cohort who completed a validated self-reported questionnaire on musculoskeletal health and who had information on siting time, physical activity, and T2DM status available were included in the analysis. Participants were excluded if they were diagnosed with type 1 diabetes. Sitting time was measured using the activPAL3 device for 8 consecutive days. Participants were included in the analysis if they had at least one valid day of device wear time. Statistical analysis was performed using progressively adjusted multiple logistic regressions modeled for each MSP outcome. The primary outcome was the impact of daily sitting time on MSP outcomes.

The results demonstrated that in patients with T2DM, increased daily sitting time was linearly and significantly associated with higher odds of knee pain, but not neck, shoulder, or lower back pain. Conversely, in patients without T2DM (including those with prediabetes), there was no significant association between sitting time and MSP. Despite these results, the study was limited by the omission of occupational physical activity, which may have influenced the results of the analysis. Nonetheless, the present study provided initial evidence regarding the association between MSP and daily sitting time in patients with T2DM.

Click to read the study in PLOS One

Image: PD

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