A Study of Diabetes Mellitus in Chronic Lower Back Pain Patients

This study examined the association of diabetes mellitus and chronic lower back pain (CLBP) with chronic widespread pain (CWP). Differences in quality of life, disability, and opioid use between CLBP patients with and without diabetes mellitus were also measured. Methods: The study was a cross-sectional study to analyze the differences between groups using data acquired from patients within the PRECISION Pain Research Registry. Pain intensity was measured with an 11-point numerical rating scale. CWP was determined using an item from the NIH minimum data set. Quality of life was measured using 5 SPADE domains of the Patient-Reported Outcomes Measurement Information System (PROMIS-29). Disability was measured using the Roland Morris Disability Questionnaire (RMDQ). Current opioid use was assessed at the baseline encounter. Results: Of the 601 patients enrolled in the registry, 128 (21.3%) reported CLBP and comorbid diabetes. A total of 45 (35.2%) of these patients reported CWP. The mean SPADE score for CLBP patients with diabetes was 58.2 vs. 56.1 for those without diabetes (p< 0.001). Similarly, the mean RMDQ score for CLBP patients with diabetes was 16.0 vs. 13.7 for those without diabetes (p=0.003). A total of 61 (47.7%) CLBP patients with diabetes used opioids vs 159 (35.6%) CLBP patients without diabetes (OR, 1.65; 95% CI, 1.109-2.453; p=0.02). Conclusion: These results highlight the importance of diabetes as a comorbidity in patients with CLBP. Comorbid diabetes often confers CWP, and is significantly associated with poorer quality of life, greater disability, and more frequent opioid use.