Evidence map›Paper›PMID 41894076›Full record

ArticleJournal of behavioral medicine2026

Chronic pain and type 2 diabetes: associations between neuropathic and nociplastic pain conditions, health behaviors, and mental health in veterans.

Jennalee S Wooldridge, Armand Gerstenberger, Jessica L Morse, VA Million Veteran Program, Marianna Gasperi

Abstract read
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In one paragraph

Article in Journal of behavioral medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jennalee S WooldridgeVA San Diego Healthcare System (VASDHS), San Diego, CA, USA.ORCID http://orcid.org/0000-0002-2815-5974
Armand GerstenbergerVA Puget Sound Health Care System (VAPSHCS), 1959 Pacific Street, Box 356560, Seattle, WA, 98195-6560, USA.
Jessica L MorseDepartment of Psychiatry and the Behavioral Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
VA Million Veteran Program
Marianna GasperiVA Puget Sound Health Care System (VAPSHCS), 1959 Pacific Street, Box 356560, Seattle, WA, 98195-6560, USA. mgasperi@uw.edu.

Funding

CSRD VA IK2 CX002107Health Services Research and Development 1I01RD001420ORD VA I01 RD001420Rehabilitation Research and Development Service 1IK2RX003634
6 · The paper itself

Abstract

Pain is common in T2D; however, the differential impact of specific types of chronic pain (i.e., diabetic peripheral neuropathy; DPN and chronic overlapping pain conditions; COPCs) on T2D outcomes is unclear. Understanding these differences may provide insight into shared mechanisms and treatment targets. Aims were to (1) Evaluate the association of COPCs with T2D in Veterans, and (2) evaluate if chronic pain conditions (DPN and COPCs) are associated with worse health behavior and mental health outcomes in Veterans with T2D. This was a retrospective observational cohort study with Million Veteran Program participants. For Aim 1 (N = 342,000), logistic regression was used to assess the associations between T2D and eight COPCs based on electronic health record diagnoses. For Aim 2 (N = 103,222), individuals with T2D were categorized into four groups: (1) no COPCs or DPN (reference), (2) DPN only, (3) COPCs only, and (4) both COPCs and DPN. Outcomes included alcohol intake, smoking, physical activity, sleep, pain rating, A1C, major depressive disorder (MDD), and posttraumatic stress disorder (PTSD). All COPCs were associated with increased odds of T2D (AORs 1.23 [migraine]–1.64 [fibromyalgia]). Among Veterans with T2D, the COPC and DPN group had the highest odds of reporting high pain levels (AOR 1.67, 95%CI [1.58–1.76]), sleep concerns (AOR 1.63, 95%CI [1.50–1.77]), MDD (AOR 2.36, 95%CI [2.24–2.49]), and PTSD (AOR 2.29, 95%CI [2.17–2.43]). Both the DPN-only group (AOR 1.93, 95%CI [1.82–2.06]) and the COPC and DPN group (AOR 1.69, 95%CI [1.55–1.83]) had higher odds of an A1C > 8%, while the COPCs-only group had lower odds of A1C > 8%. COPCs are more common among Veterans with T2D and are associated with psychiatric disorders and sleep concerns. When co-occurring with DPN, COPCs may exert an additive toll on well-being. Findings support future research to evaluate underlying mechanisms and develop interdisciplinary treatments.

Indexed as

Chronic overlapping pain conditionsHealth behaviorsMillion Veteran ProgramType 2 diabetes

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.