# Associations of Physical Activity, Sedentary Behaviour, Pain, Function and Quality of Life With Diabetes and Knee Osteoarthritis: Data From the Osteoarthritis Initiative

## TL;DR

People with both knee osteoarthritis and diabetes are less physically active and have worse quality of life compared to those with only knee osteoarthritis.

## Contribution

This study identifies the combined impact of knee osteoarthritis and diabetes on physical activity and quality of life.

## Key findings

- Comorbid knee osteoarthritis and diabetes are linked to lower moderate-vigorous activity and more sedentary time.
- Those with both conditions report higher pain and slower walking speed than those with knee osteoarthritis alone.
- T2DM alone also leads to reduced physical activity and worse quality of life compared to knee osteoarthritis alone.

## Abstract

To investigate the relation of radiographic knee osteoarthritis (RKOA) and type 2 diabetes mellitus (T2DM) to physical activity, pain, physical function, and quality of life.

Data on physical activity (light and moderate‐vigorous physical activity minutes/day, steps/day, sedentary time percent of wear time), pain, physical function (Western Ontario and McMaster Index, walking speed during 20‐m walk) and quality of life (SF‐12) from the Osteoarthritis Initiative at the 48‐month visit were included. Participants (n = 1788) were categorised into no RKOA or T2DM, RKOA‐alone, T2DM‐alone, and RKOA and T2DM. Multivariable regression models, adjusted for age, sex, and BMI, assessed the relationship of disease status to outcomes.

Compared to RKOA‐alone, RKOA and T2DM were associated with lower moderate‐vigorous physical activity (Coefficient: 4 min/day, 95% CI: [−7, −1]) and steps/day (−817 steps/day [−1291, −343]) and higher sedentary time percent (1.3%/day [−0.2, 2.8]). No significant differences were found in light physical activity (−11 min/day [−25, 2]). The RKOA and T2DM groups reported greater pain (1.0 [0.4, 1.6]) and functional limitations (3 [1, 5]), slower walking speed (−0.09 m/s [−0.12, −0.05]), and worse quality of life (−3.2 [−4.8, −1.6]). T2DM‐alone was also associated with lower physical activity and worse quality of life than RKOA‐alone.

The comorbidity of RKOA and T2DM and T2DM‐alone were associated with lower physical activity and worse quality of life than RKOA‐alone. Management should address both conditions concurrently rather than in isolation.