Introduction: Recent studies suggest that diabetics may be more likely to exhibit back pain. Correlating diabetic disease progression to the presence of back pain could provide insight into the relationship between these conditions.
Methods: A total of 67,132 patients within our institutional database were identified as having the diagnosis of either DM type I (DMI) or DM type II (DMII). Within this larger cohort, patients diagnosed with chronic back pain (CBP) were identified. In addition, patients with a history of spinal surgery were also identified. Clinical and laboratory measures of diabetic disease burden were then collected on all patients. Multinomial logistic regression analysis using a backward stepwise selection algorithm was then implemented for multivariable analysis to determine whether patient variables were associated with the diagnosis of CBP or history of spinal surgery among diabetic patients.
Results: On unadjusted analysis, highest recorded values of hemoglobin A1C (HgbA1C), LDL, triglycerides, and total cholesterol were significantly greater in diabetic patients with CPB and diabetic patients with CBP that underwent spinal surgery. Highest recorded value of HDL was significantly lower in diabetic patients with CPB and diabetic patients with CBP that underwent spinal surgery. Highest recorded BMI was also greater in patients with CBP (36.67) and patients with CBP who underwent surgery (36.63) compared to patients without CBP (34.06, p<0.001). On multinomial logistic regression analysis, increased age at time of DM diagnosis, increased duration of time with DM, presence of HTN, presence of neuropathy, increased BMI, increased levels of HgbA1C, LDL, and triglycerides, and decreased levels of HDL were independently associated with the presence of CBP.
Conclusions: Our results suggest that markers of DM disease progression are associated with the presence of back pain, suggesting that uncontrolled DM may be a contributing factor to the development of CBP.
Patient Care: BY identifying markers of disease progression in diabetes mellitus that contribute to low back pain development
Learning Objectives: By the conclusion of this session, the readers should be able to understand the connection between markers of diabetes progression and low back pain development.