ATLANTA, Georgia—Arthritis and diabetes often go hand-in-hand and unfortunately the inactivity caused by arthritis hinders management of both diseases, according to a report in the May 9, 2008 issue of the Morbidity and Mortality Weekly Report.¹

"Healthcare providers and public health agencies should consider addressing the barrier with arthritis-specific or general evidence-based self management and exercise programs," conclude the study authors led by Charles Helmick, MD, lead scientist for the federal Center's for Disease Control and Prevention's (CDC) arthritis program in Atlanta.

More than half of diabetics have arthritis

Fully 52% of people with arthritis also had diabetes during 2005 and 2007. Moreover, individuals with both diseases are more likely to be physically inactive compared with those with diabetes alone, 29.8% versus 20.1%, respectively, the study showed. This association was independent of age, sex, and body mass index (BMI). The researchers conducted a telephone survey of adults aged ≥18 in all 50 states, Guam, Puerto Rico, the District of Columbia, and the US Virgin Islands. They determined whether people had been diagnosed with diabetes or some form of arthritis as well as how often and for how long they exercised. Researchers also determined BMI based on self reports of height and weight.

Diabetes patients aged 18 to 44 had a 27.6% chance of having arthritis. By contrast, the arthritis rate in this age group is 11% in the general population. Diabetes patients aged 45 to 64 age had a 51.8% chance of having arthritis compared with 36.4% of the general population. Arthritis prevalence was 62.4% among diabetes patients ≥65 compared with 56.2% of those survey participants without diabetes, the study showed.

Translating research into practice

The bottom line is that patients with arthritis need to be encouraged to exercise, said M. Elaine Husni, MD, the director of the clinical outcome research institute in the department of orthopaedics and rheumatology at the Cleveland Clinic in Ohio. Exercise is known to improve the symptoms of both arthritis and many comorbidities including diabetes.

"We always feel that graded exercise programs are available," she told MSKreport. "It doesn't mean join a health club. If someone with arthritis has never exercised before, we introduce different modalities like physical therapy where [that person] can be evaluated," she said of the protocol at the Cleveland Clinic. "Sometimes we start with simple physical therapy and do range of motion exercises lying down." Some arthritis patients may benefit from more intensive exercise like yoga, she said.

Reference

1. Bolen J, Hootman J, Helmick CG, et al. Arthritis as a potential barrier to physical activity among adults with diabetes?United States, 2005 to 2007. MMWR. 2008;57:486-489.