TOPLINE:

Among individuals with type 2 diabetes (T2D), those with symptomatic knee osteoarthritis (OA) with average pain severity ≥ 20 on a 0-100 numeric rating scale had lower odds of achieving target glycemic control than those without knee OA.

METHODOLOGY:

• Researchers conducted a cross-sectional study to evaluate the link between symptomatic knee OA and glycemic control in adults aged 45 years or older with T2D.
• They included 351 individuals with T2D (mean age, 66.2 years; 50.7% women) recruited from three academic hospitals in Canada (March 2022-August 2023) who were assessed for symptomatic knee OA using the National Institute for Health and Care Excellence criteria (including age ≥ 45 years, activity-related pain, and absence of morning stiffness or morning stiffness of 30 minutes or less).
• The secondary exposures were painful knee OA, defined by average knee pain severity ≥ 20/100 on a 0-100 numeric rating scale, and walking difficulty.
• The primary outcome was target glycemic control, defined as A1c levels ≤ 7.0%.
• Secondary exploratory analyses assessed how painful knee OA and knee OA with walking difficulty were associated with glycemic control.

TAKEAWAY:

• Individuals with knee OA were less likely to achieve target glycemic control than those without the condition (35.0% vs 47.4%; P = .03) and were more likely to report walking difficulty, sleep disturbance, fatigue, and depressive symptoms (P < .01 for all).
• The association between knee OA and achieving target glycemic control was not statistically significant.
• Painful knee OA was significantly associated with lower odds of achieving glycemic control (adjusted odds ratio, 0.55; 95% CI, 0.33-0.94), and the association remained significant after adjusting for BMI.
• Knee OA with walking difficulty was not significantly associated with lower odds of achieving glycemic control.

IN PRACTICE:

“This adds to the current literature and suggests symptomatic knee OA may be a clinically relevant modifiable risk factor for diabetes complications through worse glycemic control,” the authors wrote.

SOURCE:

This study was led by Lauren K. King, MD, PhD, University of Toronto in Toronto, Ontario, Canada. It was published online on December 18, 2025, in Arthritis Care & Research.

LIMITATIONS:

The cross-sectional design limited the ability to infer causation between knee OA and glycemic control. The sample size may have been insufficient to detect significant associations for some analyses. The study population was highly educated, which may limit the generalizability of the findings to broader populations.

DISCLOSURES:

This study was funded by a resident research grant from the Physician Services Incorporated Foundation. Some authors reported receiving grants, honoraria, consulting fees, or royalties, and having other ties with various sources. One of the authors reported receiving peer-reviewed funding from various sources during the conduct of the study, and another author reported support for statistical analysis and manuscript writing.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.