Endocrine Abstracts

Introduction: Osteoarthritis (OA) and type 2 diabetes mellitus (T2DM) are common diseases among middle-aged and elderly persons. Aim of our study was to assess the influence of diabetic polyneuropathy (DPN) on the severity of pain in OA in patients with concomitant T2DM.

Methods: 80 female patients with OA of the knee joints in combination with T2DM were examined. The severity of gonarthrosis were assessed by Lequesne index (IL) (version 1997) using a valid questionnaire. Neurological examination included the use of the electroneuromyography (EMG).

Results: The patients were divided into two groups depending on the results of motor conduction velocity (MCV) of n. peroneus and sensory conduction velocity (SCV) of nervus suralis. Group 1 consisted of patients with normal MCV/SCV and group 2 – reduced. In group 1 with normal MCV values on n.peroneus more prominent pain associated with inflammatory changes in the knee joints by IL were noted: nocturnal pain in the knee joints was 1.32±0.78 vs 0.81±0.66 points in group 2 (P=0.04), the ability to kneel 1.73±0.46 vs 1.26±0.45 points (P=0.01). In contrast functional disorders (the intensity of pain during the descent one flight of stairs) were more pronounced in group 2 – 1.26±0.45 vs 0.8±0.68 points in group 1 (P=0.02). Reduction of SCV on sensory fibres of n.suralis intensified pain when walking: in group 1 – 0.95±0.40 vs 1.32±0.58 points in group 2 (P=0.03).

Conclusions: DPN was associated with changes in OA pain perception dependent on involvement of motor and sensory fibres. Decreased MCV masked pain associated with inflammatory changes in the knee joints. On the other hand, functional disorders associated with degenerative-dystrophic changes in OA were more marked by damage of both sensitive and motor fibres.