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. 2024 Nov 17:17:11795514241300995.
doi: 10.1177/11795514241300995. eCollection 2024.

Assessing the Effects of HbA1c Reduction on Alleviating Chronic Nonspecific Low Back Pain in Prediabetic Non-obese Patients: A Non-Randomized Controlled Trial

Ghazwan Abdulla Hasan  1 , Ahmed Dheyaa Al-Obaidi  2 , Hashim Talib Hashim  3 , Mustafa Najah Al-Obaidi  2 , Yousif Ali Al-Saady  2 , Assalah Othman  4 , Sara S Khunda  5 , Omar Saab  6 , Hasan Al-Obaidi  7 , Nooraldin Merza  8
Affiliations

Assessing the Effects of HbA1c Reduction on Alleviating Chronic Nonspecific Low Back Pain in Prediabetic Non-obese Patients: A Non-Randomized Controlled Trial

Ghazwan Abdulla Hasan et al. Clin Med Insights Endocrinol Diabetes. .

Abstract

Background: Pre-diabetes, characterized by elevated glycemic indices, poses a high risk of diabetes development, and is increasingly linked to non-specific low back pain. While mechanisms remain incompletely understood, metabolic, inflammatory, and neurological factors are implicated. Dietary interventions, including low-glycemic and anti-inflammatory diets, alongside weight management, may improve outcomes in this population.

Objectives: In this non-randomized controlled trial, we aim to evaluate the influence of decreasing HbA1c levels on reducing chronic non-specific low back pain in pre-diabetic, non-obese individuals, as well as emphasizing the importance of such a study in supporting the literature.

Methods: A non-randomized controlled single-blind clinical trial was conducted among 82 participants with chronic non-specific low back pain and pre-diabetes at an outpatient clinic in Baghdad from the 30th of January to the 22nd of September. The intervention methods aimed at reducing HbA1c levels to assess the reduction impact on alleviating chronic non-specific low back pain included dietary adjustments, sleep optimization, and correction of vitamins and minerals deficiencies. The follow-up process was conducted individually for each participant, with a monthly assessment over a period of six months.

Results: At 12 weeks a significant decrease in chronic non-specific low back pain severity was observed in patients with lower HbA1C levels yielding a P-value of .021. Similarly, at 24 weeks there was a decline in the number of patients who reported chronic non-specific low back pain, and the association to lower HbA1C levels was significant with a p-value of .005.

Conclusion: This study suggests the presence of a statistically significant association between reduction of HbA1C levels and ensuing improvement in chronic non-specific low back pain symptoms in non-obese prediabetic patients.

Keywords: Diet; Hba1c; Low back pain; hyperglycemia; obesity; pre-diabetes; vitamin D.

Plain language summary

The Effects of HbA1c Reduction on Alleviating Nonspecific Back Pain Pre-diabetes is a condition where blood sugar levels are higher than normal but not high enough to be classified as diabetes. People with pre-diabetes are at risk of developing diabetes and other health problems, including low back pain, a type of low back pain without a clear cause. Researchers believe this link might be due to problems with metabolism, inflammation, or nerve function. Changes in diet, especially focusing on lowering blood sugar levels and reducing inflammation, along with managing weight, may help people with pre-diabetes who have low back pain without a clear cause feel better. In this study, 82 people with both pre-diabetes and low back pain without a clear cause that lasted for more than 3 months took part in a clinical trial at a clinic in Baghdad. The trial lasted from January to September and was designed to see if lowering blood sugar (measured by HbA1c levels) would reduce low back pain. The participants received personalized care, which included making changes to their diet, improving their sleep, and correcting any vitamin or mineral deficiencies they had. They were followed closely for six months, with monthly check-ups. The results showed that after 12 weeks, many people who managed to lower their blood sugar levels experienced less severe low back pain. The improvement was even more noticeable after 24 weeks, as fewer people reported ongoing low back pain, and this improvement was strongly linked to lower blood sugar levels. In conclusion, the study found that reducing blood sugar levels in people with pre-diabetes who are not obese can significantly improve symptoms of low back pain. This suggests that managing blood sugar could be an important way to relieve low back pain without a clear cause.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Figure 1.
CONSORT flow diagram.
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