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The Impact of Diabetic Neuropathy on Balance and on the Risk of Falls in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study
Authors:Bogdan Timar  Romulus Timar  Laura Gai??   Cristian Oancea  Codrina Levai  Diana Lungeanu
Abstract:IntroductionDiabetic neuropathy (DN) is a prevalent complication of Type 2 Diabetes Mellitus (T2DM) with a major impact on the health of the affected patient. We hypothesized that mediated by the dysfunctionalities associated with DN’s three major components: sensitive (lack of motion associated sensory), motor (impairments in movement coordination) and autonomic (the presence of postural hypotension), the presence of DN may impair the balance in the affected patients. Our study’s main aim is to evaluate the possible association between the presence and severity of DN and both the balance impairment and the risk of falls in patients with T2DM.ResultsThe presence of DN was associated with significant decreases in the BBS score (40.5 vs. 43.7 points; p<0.001) and SLS time (9.3 vs. 10.3 seconds; p = 0.003) respectively increases in TUG time (8.9 vs. 7.6 seconds; p = 0.002) and FES-I score (38 vs. 33 points; p = 0.034). The MNSI score was reverse and significantly correlated with both BBS score (Spearman’s r = -0.479; p<0.001) and SLS time (Spearman’s r = -0.169; p = 0.017). In the multivariate regression model, we observed that patient’s age, DN severity and depression’s symptoms acted as independent, significant predictors for the risk of falls in patients with T2DM.ConclusionsThe presence of DN in patients with DM is associated with impaired balance and with a consecutively increase in the risk of falls.
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