Risk of fall for people with diabetes

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 RehabilitationThe 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.