{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:45:03Z","timestamp":1785537903576,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,7,19]],"date-time":"2013-07-19T00:00:00Z","timestamp":1374192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the relationship between pain and HbA<jats:sub>1c<\/jats:sub> levels in a predominantly black population with diabetes, and to determine whether self\u2010management behaviours (exercise and diet) and symptoms of depression mediate this relationship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed cross\u2010sectional data from 417 community\u2010dwelling individuals with diabetes in rural Alabama, <jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>. Binary logistic regression was used to analyse the relationship between pain and HbA<jats:sub>1c<\/jats:sub> levels, defined as relatively good [\u2264 64\u00a0mmol\/mol (\u2264 8.0%)] and relatively poor [&gt; 64\u00a0mmol\/mol (&gt; 8.0%)], after adjusting for sociodemographics, insulin use, medication count, cigarette smoking history and body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>). We examined the mediating roles of exercise, diet, and symptoms of depression using bootstrapping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants were primarily black (86.6%), female (76.1%) and reported an annual income of \u2264$20,000 (52.7%). Their mean (<jats:sc>sd<\/jats:sc>) age was 59.6 (12.8) years. The majority of the participants reported moderate to extreme pain (71.5%). Participants reporting pain were more than twice as likely to have HbA<jats:sub>1c<\/jats:sub> levels &gt; 64\u00a0mmol\/mol (8.0%) in the fully adjusted model (odds ratio 2.33 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.28\u20134.24]; <jats:italic>P<\/jats:italic> &lt; 0.05). Diet significantly mediated the relationship between pain and HbA<jats:sub>1c<\/jats:sub> control (\u03b2\u00a0=\u00a00.06; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.01\u20130.17), but only in the unadjusted model. Exercise and symptoms of depression were not significant mediators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A significant independent relationship between pain and HbA<jats:sub>1c<\/jats:sub> control was found in this mainly black population, which was not explained by self\u2010management behaviours or symptoms of depression. Future research is needed to delineate the mechanism by which pain influences HbA<jats:sub>1c<\/jats:sub> control, especially among black people with diabetes on low incomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12264","type":"journal-article","created":{"date-parts":[[2013,6,24]],"date-time":"2013-06-24T15:00:15Z","timestamp":1372086015000},"page":"1466-1471","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Association of pain with HbA<sub>1c<\/sub> in a predominantly black population of community\u2010dwelling adults with diabetes: a cross\u2010sectional analysis"],"prefix":"10.1111","volume":"30","author":[{"given":"M. S.","family":"Herbert","sequence":"first","affiliation":[{"name":"Department of Psychology University of Alabama at Birmingham Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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M.","family":"Safford","sequence":"additional","affiliation":[{"name":"Division of Preventive Medicine School of Medicine University of Alabama at Birmingham Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,19]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States","author":"CDC","year":"2011"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-8-200904210-00005"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2228"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.1.65"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2010.02971.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2012.01336.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110040"},{"key":"e_1_2_7_9_1","first-page":"216","article-title":"Prevalence of musculoskeletal disorders in patients with type 2 diabetes mellitus: a pilot study","volume":"11","author":"Douloumpakas I","year":"2007","journal-title":"Hippokratia"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2010.12.008"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-008-0629-6"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01943.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.21.3278"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.20.2433"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2012.02.005"},{"key":"e_1_2_7_16_1","unstructured":"in2it (II) Analyzer [article online] 2012. 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