Aim. To investigate the associations between diabetes and musculoskeletal pain, osteoarthritis, osteoporosis, and rheumatoid arthritis. Methods. Self-reported data were provided by the nationwide Danish National Health Survey 2013. Inclusion criteria were age≥40 years and known diabetes status. The exposure variable was diabetes, and the outcome variables included musculoskeletal pain during the last 14 days in three body sites (back/lower back, limbs, and shoulder/neck), osteoarthritis, osteoporosis, and rheumatoid arthritis. Logistic regression analyses adjusted for age, gender, BMI, education, marital status, and physical activity were performed. Results. 9,238 participants with diabetes were 65.6±11.0 (mean±SD) years old; 55.6% were males. 99,980 participants without diabetes were 59.2±11.8 years old; 46.7% were males. Diabetes was associated with back/lower back pain (OR 1.2 (CI 95% 1.1-1.2), p<0.001), pain in the limbs (1.4 (1.3-1.4), p<0.001), shoulder/neck pain (1.2 (1.1-1.3), p<0.001), osteoarthritis (1.3 (1.2-1.4), p<0.001), osteoporosis (1.2 (1.1-1.4), p=0.010), and rheumatoid arthritis (1.6 (1.4-1.7), p<0.001). In participants with diabetes, physical activity was associated with reduced pain (e.g., back/lower back pain (0.7 (0.6-0.7), p<0.001)). Conclusion. Diabetes was associated with elevated odds of having musculoskeletal pain. Diabetes was also associated with elevated odds of having osteoarthritis, osteoporosis, and rheumatoid arthritis. The most frequent disease in individuals with diabetes was osteoarthritis. The reported pain may have negative impacts on the level of physical activity. Health-care professionals should remember to inform patients with diabetes that musculoskeletal pain, osteoarthritis, osteoporosis, and rheumatoid arthritis are not contraindications to exercise training.

Background: The number of chronic renal failure patients treated by hemodialysis (HD) is continuously increasing. Most patients have reduced physical capacity and have a high risk of cardiac and vascular diseases. The aim of this study was to determine the effects of 5 months physical exercise of HD patients’ physical capacity, self-rated health and risk factors for cardiovascular disease. Methods: 33 HD patients were included in the study. Inclusion criteria: HD for more than 3 months, age >18 years. Exclusion criteria: Diabetes mellitus, symptomatic cardiovascular disease, musculoskeletal limitations, severe peripheral polyneuropathy, inability to speak Danish or English, dementia or other mental disorders. The patients were randomly assigned to an exercise group (EG, n = 22) or a control group (CG, n = 11). Prior to randomization, baseline testing was performed. The effects were measured by aerobic capacity, ‘2-min stair climbing’, ‘squat test’, self-rated health (SF36), blood pressure and lipids. All tests were carried out by blinded testers. The intervention consisted of 1 h of physical exercise twice a week for 5 months. Results: 20 patients completed the intervention. Attendance was 74% of all sessions. There were no dropouts caused by complications related to the intervention. The EG had a significant increase in aerobic capacity, ‘squat test’ and Physical Function and Physical Component Scale (SF36). No significant changes were observed in any of the parameters in the CG. Conclusion: Physical exercise twice a week for 5 months increases physical function and aerobic capacity in HD patients. An exercise program with only two exercise sessions per week seems easy to implement in clinical practice with high attendance among participants. Further investigation is needed to determine the effects on blood pressure and lipids. There were no medical complications related to the exercise program.

Background/Aims: It is relevant to investigate health-related quality of life (HRQOL) in dialysis and chronic kidney disease (CKD) patients in order to optimise treatment. The aim of this study was to investigate HRQOL in dialysis and CKD patients, to compare results from patients treated with hemodialysis (HD) and peritoneal dialysis (PD) and to investigate the prediction of dialysis quality control parameters (blood hemoglobin, plasma albumin, and Kt/V) and tobacco smoking in disease-specific HRQOL. Methods: Seventy-one HD, 59 PD, and 63 CKD patients participated in the study. Dialysis quality control parameters were measured and the patients completed the questionnaire Kidney Disease Quality Of Life. Results: PD patients rated Dialysis Staff Encouragement and Patient Satisfaction better than HD patients (p≤ 0.05). Dialysis patients scored significant lower than the general population in all generic HRQOL scales (p ≤ 0.01), whereas CKD patients scored lower than the general population in 5 of 8 scales (p ≤ 0.05). The dialysis quality parameters did not predict dialysis patients’ disease specific HRQOL, but tobacco consumption was independently associated with low scores on a number of HRQOL scales. Conclusion: Based on the results, it is suggested to include elements of HRQOL as a supplement to standard quality control parameters. It is also suggested routinely to include information of the beneficial effects of physical activity already in the predialysis program, and to focus on smoking as a very important risk factor.

Objective: Along with survival and other types of clinical outcome, physical, mental and social well‐being are important indicators of the effectiveness of the medical care that haemodialysis (HD) patients receive. The present cross‐sectional study was designed to assess self‐rated health in HD patients from a large Danish HD centre compared to a Danish general population sample with similar sex and age distributions. Furthermore, employment status and associations between self‐rated health and clinical, social and demographic factors were investigated. Material and Methods: A total of 150 patients were included. They were asked to complete the Short Form 36 (SF‐36) questionnaire and additional questions concerning education and employment status. The SF‐36 consists of eight scales representing physical, social, mental and general health. Clinical, biochemical and dialysis adequacy data were obtained from hospital records. Results: A total of 112 patients completed the questionnaire, giving a response rate of 75%. Compared to the general population sample, HD patients scored significantly lower on all eight SF‐36 scales (p < 0.01), with the greatest difference being observed for items concerning physical functioning. No correlation was found between any of the eight scales and estimates of dialysis adequacy. Of patients aged 18–60 years, 22% were in employment. Conclusion: In a large group of Danish HD patients, self‐rated health (and especially physical function) was found to be substantially impaired compared to the general population and only a small proportion of patients were employed. We believe that results obtained using the SF‐36 questionnaire represent an independent marker of health status in HD patients and should be considered, together with common clinical outcome measures, when monitoring patients. Furthermore, we believe that self‐rated health questionnaires are a useful tool for evaluating the need for and the effects of physical activity programmes in a dialysis unit.