Diabetes and postural stability: review and hypotheses

Among the complications associated with diabetes mellitus is postural control. The authors reviewed 28 studies in the literature that focused on the magnitudes of postural sway that people with and without diabetes exhibit. The general observation is that postural sway is greater for people with diabetes, especially if their condition includes neuropathy. Peripheral sensory neuropathy seems to be the primary factor, but the available evidence does not rule out diabetes per se, other neuropathies (central, autonomic, motor), or an inability to exploit fully optical and inertial information about posture. The authors' review raises the issue of foot disorders and the possibility of increased sway as a useful adaptation; it also calls for better neuropathy assessments, postural tasks, and measures.