Risk of fall for people with diabetes

Abstract

Purpose: To examine the risk of fall for people with diabetes compared with healthy control subjects. Correlation between tactile sensation and postural control was examined for subjects with diabetes. Methods: Subjects with type 2 diabetes were classified into two groups: (i) diabetes without neuropathy (n = 23) and (ii) diabetic peripheral neuropathy (DPN) (n = 9). Age-matched healthy control subjects (n = 32) were recruited. Tactile sensation, equilibrium scores (ES), strategy scores and sensory analysis scores from the Sensory Organization Test (SOT) were compared among the groups. Results: Subjects with diabetes without neuropathy demonstrated impaired postural control upon the disruption of somatosensory inputs. Subjects with DPN lost balance upon being deprived of visual inputs. A decrease in tactile sensation was associated with a decrease in the ESs in all subjects with diabetes (r = −0.35 to −0.77; p < 0.05), and they tend to use more hip strategy for postural control upon being deprived of visual inputs. Conclusions: Different postural control strategies are adopted by various subgroups of subjects with diabetes. Subjects with DPN demonstrated a significant shift from ankle to hip strategies for balance tests when vision was deprived.

Implications for Rehabilitation

• The severity of diabetic peripheral neuropathy (DPN) is associated with the risk of fall.

• Different compensatory strategies in balance control have been adopted by different subgroups of people with diabetes.

• In order to minimize the risk of fall, specific balance training program should be offered to different subgroups of people with diabetes.

• The balance training should emphasize on optimizing the competence of their existing compensatory postural control strategies.

• Balance
• diabetes
• falls
• peripheral neuropathy

Acknowledgements

We are grateful to all staff members of the diabetes clinics for their support and to all of the subjects who participated in this study.