Objective To investigate the prevalence of diabetes mellitus among middle-aged and elderly patients with chronic pain in Beijing city, Jiangxi province, and Chongqing city, China, and to provide a reference for the development and improvement of pain management strategies for this population.

Methods From January to August 2023, a multi-stage stratified random sampling method combined with convenience sampling was used to recruit 4320 outpatients aged ≥45 years with self-reported pain duration >3 months from six tertiary and six secondary general hospitals in Beijing city, Jiangxi province, and Chongqing city. A questionnaire survey was conducted to analyze the prevalence of diabetes mellitus among middle-aged and elderly patients with chronic pain, the influencing factors of pain intensity, and the factors that alleviate or exacerbate pain, as well as treatment status.

Results Among the 4 151 middle-aged and elderly patients with chronic pain finally included in the analysis from the three provinces/cities, 736 had diabetes mellitus, with a prevalence of 17.7%. Among the 736 patients with chronic pain and diabetes mellitus, 163 (22.1%) had mild pain, 441 (59.9%) had moderate pain, and 132 (17.9%) had severe pain. Multivariable ordinal logistic regression analysis showed that living in rural areas, strenuous physical activity, having other medical histories, and having depressive symptoms were risk factors for increased pain intensity in patients with chronic pain and diabetes mellitus. Common pain-relieving factors for patients with diabetes mellitus were bed rest (60.9%), rest days (47.0%), and appropriate massage (38.3%), while aggravating factors were physical fatigue (59.8%), inappropriate exercise (44.8%), and prolonged sitting (35.2%). A total of 672 patients with chronic pain and diabetes mellitus received pain treatment, with a treatment rate of 91.3%. Common pain treatment methods included topical medications (61.9%), oral analgesics (55.1%), and moderate rest (48.7%).

Conclusions The prevalence of diabetes mellitus among patients with chronic pain is high. Patients with diabetes mellitus living in rural areas, with other medical histories, engaging in strenuous physical activity, and experiencing depressive symptoms are more likely to experience increased pain. Moderate rest and appropriate exercise can effectively alleviate pain in patients with diabetes mellitus.