Effects of Diabetic Neuropathy on the Postural Stability of Adults with Type 2 Diabetes Mellitus

Abstract

Diabetic peripheral neuropathy (DPN) is one of the most common complications, which occurs in 50–70% of people with Type 2 diabetes mellitus (T2DM). The disease usually affects the peripheral nerves and can cause loss of sensation in the feet, leading to impaired body equilibrium during quiet stance and gait, and elevated risk of falls. A total of 38 non-insulin-dependent T2DM adults (mean age 53.21 ± 7.74 years) – 18 with DPN and 20 without DPN, and 20 age- and sex-matched controls took part in the study. The DPN group was selected with standard clinical criteria and a Bulgarian version of the Michigan neuropathy screening instrument. Postural stability was evaluated with static posturography under two visual conditions (eyes open and eyes closed) on firm and soft support. Both diabetic groups exhibited significantly higher postural instability compared with the healthy controls, as well as stronger visual dependence. While standing on firm support, subjects with DPN exhibited significantly higher postural instability than those without DPN in the closed eyes condition only, whereas when standing on soft support, their postural stability was significantly more impaired compared with the diabetic subjects without DPN in both experimental conditions (open and closed eyes). A better understanding of the changes in postural stability in persons with T2DM would contribute to early diagnostics, rehabilitation and prevention of DPN.