Age, racial, and gender differences in diabetes mellitus-related impairment and ankle pain and stiffness: A population-based study

Objectives: Neuropathic changes in the ankle joint frequently occur in the course of diabetes mellitus (DM). They may present with significant osseous destruction and malposition of the articular constituents. The objective of this study is to test the null hypothesis that there are no age, racial, and gender differences in DM-associated impairment and ankle pain. Methodology: National population-based data from the 1998 National Health Interview Survey were analyzed using correlational analysis to measure the possible association between DM-related impairment and hypertension and ankle pain and stiffness among persons with DM in different age, racial, and gender groups. Results: Correlational analysis showed that DM-related disability was associated with ankle pain and stiffness, especially among women in the 41-60 age group from racial groups other than whites and African-Americans (r=+.299, p<.004, N=78) and African-American women in the 61 years and older age group (r=+.130, p<.018, N=261). Possible predictor variables, such as arthritis impairment, BMI, and frequency of vigorous exercise, were statistically adjusted for and did not significantly alter these results. Conclusions: DM-related disability is more likely to be positively related to ankle pain and stiffness among racially diverse middle-aged women and older African-American women, suggesting that these women are at greatest risk for diabetic impairment and ankle pain and stiffness.