The effects of 2-year SYSADOA treatment on glycemic level in patients with comorbid primary knee osteoarthritis and type 2 diabetes mellitus.

Authors

Yanonut Tawansareewattana, Panparamee Amornwacharapong, Itthiphat Khongjaew, Kasidit Jirawatthanasakda, Pariphat Chompoonutprapa, Todsapon Siriwat, Thanin Chattrapiban, Artit Laoruengthana

Published in

Journal of diabetes and metabolic disorders. Volume 25. Issue 2. Pages 254. Epub Sep 11, 2026.

Abstract

To evaluate the effects of long-term use of symptomatic slow-acting drugs for osteoarthritis (SYSADOA), including glucosamine and diacerein, on glycemic control in patients with knee osteoarthritis (KOA) and type 2 diabetes mellitus (T2DM).
We conducted a retrospective cohort study of patients aged ≥ 40 years with KOA and T2DM. Participants were categorized into glucosamine, diacerein, and non-SYSADOA groups. Glycemic outcomes, including glycated hemoglobin (HbA1c) and fasting blood glucose (FBG), were assessed every three months over 24 months. Baseline covariables were collected to control for potential confounding factors, including sex, age, body mass index, baseline glycemic control (poor glycemic control defined as HbA1c > 7% or FBG > 130 mg/dL), number of antidiabetic drug classes, and the use of NSAIDs, opioid analgesics, lipid-lowering agents, and antihypertensive medications. Longitudinal changes were analyzed using multivariable multilevel Gaussian regression time-by-group interaction.
A total of 409 patients were included in the FBG analysis and 304 in the HbA1c analysis. Baseline characteristics were generally comparable across treatment groups. Over the 24-month follow-up period, neither glucosamine nor diacerein was associated with significant changes in glycemic outcomes compared with non-SYSADOA use. Adjusted baseline differences in HbA1c were 0.06% (95% CI -0.15 to 0.28) for glucosamine and - 0.05% (95% CI -0.32 to 0.21) for diacerein. Corresponding adjusted differences in FBG were - 2.35 mg/dL (95% CI -8.35 to 3.66) and - 3.32 mg/dL (95% CI -11.20 to 4.55).
SYSADOA use was not associated with clinically meaningful changes in glycemic control over 24 months in patients with KOA and T2DM.
The online version contains supplementary material available at https://doi.org/10.1007/s40200-026-02069-1.

PMID:
42732213
Bibliographic data and abstract were imported from PubMed on 13 Sep 2026.

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