Almost half of adults with type 2 diabetes report acute and chronic pain, and close to one quarter report neuropathy, fatigue, depression, sleep disturbance and physical or emotional disability, according to a study of more than 13,000 adults conducted by researchers at the San Francisco VA Medical Center, the University of California, San Francisco and the Kaiser Permanente Division of Research in Oakland, CA. The researchers also found significant rates of shortness of breath, nausea and constipation.
The authors suggested that palliative care become part of standard management of the disease.
Patients in the study reported significant pain and non-pain symptoms across the entire course of the disease, among all age groups, with prevalence increasing as people neared the end of their lives.
The findings appear in the Journal of General Internal Medicine and are available online on August 3, 2012 at www.SpringerLink.com. According to the authors, it is the largest observational study to assess a full range of pain and non-pain symptoms among patients with type 2 diabetes, and the first to characterize the kinds of symptoms that patients experience.
"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 Dr. Rebecca Sudore, a staff physician at SFVAMC and associate professor of medicine at UCSF.
She noted that tens of millions of Americans have type 2 diabetes.
"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 principal investigator of the DISTANCE and Diabetes & Aging Studies, and senior research scientist at Kaiser. "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."