Prevalence and associated factors of primary headache among patients with diabetes mellitus in the Qassim region, Saudi Arabia: a cross-sectional study

Previous studies have reported a possible association between diabetes mellitus (DM) and primary headache; however, no studies have been conducted in the Arabic Gulf region, including Saudi Arabia. This cross-sectional study investigated the prevalence of primary headache and its determinants in patients with DM at two primary healthcare centers in Qassim region, Saudi Arabia. Systematic sampling was employed to enroll diabetic patients (types 1 and 2). Data including sociodemographic information, clinical data, and a headache assessment questionnaire were collected through direct interviews and by reviewing patients’ medical records. We enrolled 313 patients (183:130 female/male) in this study, with a response rate of 94.7%. The median (IQR) age of the participants was 60 (52.5–65) years, with a median (IQR) diabetes duration of 6 (3–12) years. The prevalence of primary headaches was 36.4%. Multivariable analysis demonstrated that HbA 1c levels (adjusted odds ratio [AOR] = 1.26; 95% confidence interval [CI]: 1.06–1.48; p = 0.007) and T2DM (AOR = 3.13; 95% CI: 1.74–5.62; p < 0.001) were independently and positively associated with primary headache. In contrast, mean corpuscular hemoglobin concentration (AOR = 0.80; 95% CI: 0.65–0.98; p = 0.031) and high educational level (AOR = 0.47; 95% CI: 0.22–0.98; p = 0.044) were inversely associated with primary headache. In this study, one in three diabetic patients experienced primary headache. Clinicians may inquire about symptoms of primary headache among such patients during routine checkup, particularly those with uncontrolled DM and T2DM.