Preventing knee pain in at-risk adults with diabetes

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Preventing knee pain in at-risk adults with diabetes

Knee pain in older adults, often caused by osteoarthritis, usually means more visits to the doctor and also can be an indicator of disability.

A study led by Daniel White, assistant professor of physical therapy at the University of Delaware, found that regular exercise and a healthy diet may decrease the short-term onset of knee pain for overweight adults with Type 2 diabetes mellitus.

White's article published in Arthritis Care and Research, "Can an Intensive Diet and Exercise Program Prevent Knee Pain Among Overweight Adults at High Risk'' was an editor's pick in the July issue and was named as a key study for 2015 at Osteoarthritis Society's international meeting. Old age and obesity are major risk factors for knee osteoarthritis. Researchers asked whether an intensive program of weight loss combined with exercise could prevent the onset of knee pain among this cohort. White said “Preceding this study, we didn't have exact information, to claim that diet and exercise actually worked to prevent knee pain," but now we do have a study

The study compared subjects receiving intensive lifestyle intervention (ILI) to a group receiving standard diabetes mellitus support and education (DSE), measuring knee pain at the end of one year and four years. White and his colleagues conducted a secondary analysis of the Action for Health in Diabetes (Look AHEAD) study, a randomized intervention of trial adult’s ages 45 to 76 years who were obese and had Type 2 diabetes mellitus that started in 2001. In this analysis, a subcohort of 2,889 subjects was involved who reported no knee pain at baseline, but were at high risk due to obesity.

According to American Diabetes Association guidelines, the primary method of achieving weight loss by low caloric intake and limits intake of total calories from fat to 30 percent while mandating at least 10 percent of calories to be obtained from protein. Intervention for exercise relied heavily on unsupervised exercise at home, with a gradual progression to 175 minutes per week of moderate to vigorous physical exercise. For most participants, the study notes, that brisk walking with moderate-intensity encouraged as a primary type of physical activity. An intensive program of diet and exercise was statistically significant protective effect against the development of knee pain in the short term among overweight adults with diabetes.

At four-year mark, this difference decreased to five percent and was no longer statistically significant, might be a consequence of participants not being able to stay with prescribed diet and exercise regimen over the four-year period. "They exhibit that the recommendations of exercise and diet do make a difference for preventing the development of knee pain among those who are at high risk." White said. Also, knee pain is the most common type of chronic lower body pain among middle to older age and is responsible for disability than any other chronic condition.

"I felt it was important to investigate whether exercise combined with diet did in fact protect against the development of knee pain." White said

University of Delaware
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