Almost half of adults with type 2 diabetes have acute or chronic pain, according to a study of over 13,000 adults conducted by researchers at the San Francisco VA Medical Center, the University of California, San Francisco and Kaiser Permanente. Many patients also complained of fatigue, depression, difficulty sleeping, nausea, constipation and shortness of breath.
“Adults living with type 2 diabetes are suffering from incredibly high rates of pain and non-pain symptoms, at levels similar to patients with living with cancer,” said lead author Rebecca Sudore, MD, a staff physician at the San Francisco VA hospital and associate professor of medicine at UCSF.
According to the American Diabetes Association, millions of Americans have Type 2 diabetes, the most common form of diabetes. In type 2 diabetes, the body doesn’t produce enough insulin, which is needed to take glucose (sugar) from the blood into the cells. Excess glucose in the blood leaves cells starved for energy, and can damage blood vessels, kidneys, eyes, nerves or the heart. The damage can lead to serious illness and death. African-Americans, Hispanics and Asian-Americans are more at risk of the disease.
“The field of diabetes has focused, and rightfully so, on decreasing patients’ blood sugar, blood pressure and cholesterol levels in attempt to prevent complications such as cardiovascular disease, kidney failure, amputations and blindness,” said Andrew J. Karter, PhD, a senior research scientist at Kaiser Permanente. “However, our observations provide an important wake up call for clinicians to not wait until the latest stages of diabetes to focus on these patient-reported outcomes, but rather to consider early palliative care as part of usual chronic disease management.”
Palliative care is specialized medical care for people with serious illness that provides extra support and treatment. Seriously ill patients who receive palliative care often live longer and with a better quality of life.
“Palliative care has already begun to be woven into the care provided to patients with cancer, heart failure and kidney failure,” Sudore said. “Our results highlight the need to expand diabetes management to also include the palliative care model.”
The research team surveyed 13,171 adults with type 2 diabetes, aged 30 to 75 years, who were enrolled in a diabetes study in northernCalifornia. Adults over the age of 60 reported more physical symptoms such as pain, whereas adults younger than 60 reported more fatigue and depression.
The study is published in the Journal of General Internal Medicine. According to the authors, it is the largest observational study to assess the range of pain and non-pain symptoms among patients with type 2 diabetes.