People with diabetes often suffer from chronic and sometimes severe pain, and this can create difficulties for them in the management of their condition and with self-care activities, researchers have found.

“Many adults experience chronic pain, yet little is known about the consequences of such pain among individuals with diabetes,” Dr. Sarah L. Krein, of the University of Michigan Medical School, Ann Arbor, and colleagues write in the medical journal Diabetes Care.

The researchers examined the effects of chronic pain on diabetes self-management among 993 patients receiving care through the Department of Veterans Affairs.

Chronic pain was defined as the presence of pain most of the time for at least 6 months during the past year. Information was collected from the participants using a written survey.

About 60 percent of the subjects reported having chronic pain. They tended to be younger than those without chronic pain, female, more likely to be using insulin and overweight.

A significant association was seen between chronic pain and poorer overall diabetes control. Patients with chronic pain also had more difficulty following recommended exercise and eating plans.

“Among patients with chronic pain, overall self-management was also significantly poorer for those who indicated their pain was severe or very severe compared with those who rated their pain as mild or moderate,” the team reports. “Specifically, patients with severe pain reported more difficulty with taking diabetes medications and with exercise.”

Based on the findings, Krein’s group suggests that “chronic pain may be a major limiting factor in the performance of certain self-care behaviors and thereby reinforces the need to proactively address such potential competing demands” for people with diabetes.

SOURCE: Diabetes Care, January 2005.