Vestibular and Proprioception Deficits in Adults with Controlled Diabetes Mellitus II Causes Postural Control Instability

Abstract

Objectiveindividuals with controlled type two diabetes (cDM) often are unaware of balance impairments, although these changes are occurring and may become impairments. Thus, the objective of this study is to make an individual comparison and characterization of each system involved during standing balance (vision (Vi), proprioceptive (Pro) and vestibular (Ve) tasks in people with DM and healthy‐control individuals and identify the most affected system. 
MethodsFourteen participants with DM (age 59 ± 5, BMI 29 ± 3 kg/m2and 8 ± 6 years since diagnosis) and eighteen healthy participants (age 57 ± 5, BMI 27 ± 3 kg/m2) participated in this study. Postural stability during still standing for 20 seconds was assessed using a pressure mat by measuring center of pressure (CoP). Static postural control was evaluated during eight sensory conditions that perturbed or stimulated the visual (Vi), proprioceptive (Pro) and vestibular (Ve) systems.ResultsA Mann‐Whitney U Test was used to compare CoP data between DM and normal subjects. When pitching the head with the eyes open while standing on the foam pad, CoP displacement was significantly greater in DM subjects, indicating increased body sway and less balance control (CoP displacement: 39.65 ± 18.6 cm2 in DM vs. 24.33 ± 9.5 cm2 in controls, P= 0.009).ConclusionsThe conditions in which the Ve and Pro systems were challenged, the group with DM had a greater CoP displacement when compared to the control group. This suggests that in patients with DM without a diagnosis of neuropathy, postural control changes are already detected making them unstable by affecting their balance.