Postural control in type 2 diabetes mellitus: the role of diabetic neuropathy

To examine postural control in people with type 2 diabetes mellitus (T2DM) with and without diabetic neuropathy (DN) using center of pressure (CoP) measures under varying sensory and cognitive conditions.

In this cross-sectional study, adults aged ≥ 40 years with T2DM for at least one year. Neuropathy was classified as severe peripheral neuropathy (DPN) or autonomic neuropathy (DAN), defined by vibration perception threshold ≥ 50 V, ≥2 abnormal cardiac autonomic reflex tests, or orthostatic hypotension. Postural control was assessed by CoP^Area and CoP^Velocity under different sensory and cognitive conditions. Regression analyses were adjusted for demographic factors, physical performance, and fall-associated medication. Exploratory analyses were performed by neuropathy subtype.

99 participants were included, 49 with DN and 50 without. The DN group was older (66.8 vs. 60.8 years) and more often male (75.5% vs. 52%). DN was associated with greater CoP^Area (β = 0.56, p = 0.006). Exploratory analyses suggested larger CoP^Area in participants with DAN alone (β = 0.76, 95% CI 0.36-1.16) or combined with DPN (β = 0.70, 95% CI 0.13-1.34), whereas DPN alone was not associated with CoP^Area.

DN was linked to impaired postural control, with indications of differences by neuropathy subtype. CoP assessment may help identify people with T2DM at increased risk of falls.