Sedentary Lifestyle Leads to Increased Osteoarthritis Among Diabetic Patients

Introduction As a disease of aging, osteoarthritis affects many Americans. It can be coincident with diabetes, which can increase the risk of joint degradation needing joint replacement. A lack of physical activity, often concurrently present in type 2 diabetic patients, may also increase osteoarthritis risk. The resulting sedentary lifestyle could exacerbate arthritic changes in this population. We compare 5-year incidences of osteoarthritis, joint pain, and joint replacement between matched sedentary and non-sedentary diabetic patients. Methods Diabetic patients from 2010-2018 were identified in a national database, and sedentary patients were propensity-matched 1:1 to non-sedentary patients (n=2,238 pairs). Osteoarthritis and joint pain within 5 years were compared utilizing chi-square. A sub-cohort of osteoarthritic diabetic patients with/without sedentary lifestyle was also propensity-matched (n=1,033 pairs), comparing total knee arthroplasty (TKA) and total hip arthroplasty (THA) incidences within 5 years. Results Compared to non-sedentary diabetic patients, sedentary diabetics had more osteoarthritis (29.6% vs 38.9%, p<0.001) and significantly higher 5-year incidences of joint pain (27.3% vs 36.0%, p<0.001). For diabetic patients with osteoarthritis, non-sedentary and sedentary patients had similar rates of TKA (2.7% vs 4.1%, 1.5% vs 1.7%, p=0.114) or THA (p=0.726) at 5 years. Conclusion Lack of physical activity among diabetic patients may exacerbate both osteoarthritis and joint pain within 5 years. Conversely, lack of physical activity did not increase joint replacements. Osteoarthritic changes may be augmented with a sedentary lifestyle, but are not severe enough to necessitate arthroplasty. Sedentary diabetic patients represent a target population for early intervention and recovery exercises to improve joint function and prevent osteoarthritis progression.