Mobility Impairment in Type 2 Diabetes

Abstract

The increasing prevalence of type 2 diabetes is a major health concern. Reducing the vascular complications of diabetes has been a primary focus of treatment. However, the less-recognized complications of physical disability, cognitive impairment, and depression that impact on quality of life (QOL) are also important primary care considerations in older patients with diabetes. Diabetes has been associated with a greater risk of decline in function and increased prospect of severe disability (1,2). Studies have sought to identify relationships or causal pathways between the syndromes of mobility, disability, and neuropsychological function in adults with type 2 diabetes (1,3). Few have simultaneously examined these factors potentially modifiable by physical activity (4) across multiple domains or at more than one point in time. The dose of aerobic and resistance exercise necessary to achieve metabolic benefits in clinical trials has sometimes led to poor compliance (5). Older adults with diabetes, often characterized by long-term sedentariness, overweight/obesity, and multiple comorbidities, may demonstrate better adherence to a low-intensity, low-impact exercise, such as Tai Chi. Although Tai Chi has demonstrated improved balance, gait speed, muscle strength, cardiorespiratory fitness, and QOL in older adults (6–13), it has never been tested specifically in a diabetic cohort for benefits across multiple domains. If Tai Chi was shown to be effective for mobility and other health outcomes relevant to this cohort, it may present a viable alternative exercise modality. The aim of this study was to examine the physiologic impairments associated …