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Published on: December 11, 2013
Postural Instability and Fall Risk in Type 2 Diabetes: A Cross-Sectional Study Using Posturography and Video Head
Andrea Lund1, Mathias Alrø Fichtner Bendtsen2, Henning Andersen3
1Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Aarhus University Hospital; Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Archives of Physical Medicine and Rehabilitation
|August 6, 2026
Summary
Balance impairment and increased fall risk are common in type 2 diabetes mellitus (T2DM), particularly with diabetic polyneuropathy (DPN). Computerised posturography effectively identifies these risks, while vestibular testing shows limited utility.
Area of Science:
- Neurology
- Diabetology
- Gerontology
- Biomechanics
Background:
- Type 2 diabetes mellitus (T2DM) is a growing global health concern.
- Diabetic polyneuropathy (DPN) is a common complication of T2DM, affecting sensory and motor functions.
- Impaired balance and increased fall risk are significant issues for individuals with T2DM, impacting quality of life and healthcare costs.
Purpose of the Study:
- To investigate vestibular function, postural stability, and fall risk in individuals with T2DM.
- To compare individuals with T2DM and DPN, T2DM without DPN, and healthy controls.
- To determine the role of vestibular dysfunction and postural instability in fall risk among T2DM patients.
Main Methods:
- A cross-sectional study involving 128 adults: 51 with T2DM and DPN, 38 with T2DM without DPN, and 39 healthy controls.
- Vestibular function assessed using the video head impulse test (vHIT).
- Postural stability measured by computerised posturography (F2-F4 sway, Stability Index, Fall Risk Index), with fall concern and history assessed via questionnaire and self-report.
Main Results:
- Abnormal vHIT findings were rare (7%) and did not differ between groups.
- Individuals with T2DM and DPN showed significantly higher F2-F4 sway and Stability Index compared to other groups.
- Increased F2-F4 sway was associated with heightened fall concern and a history of falls, confirmed by logistic regression.
Conclusions:
- Computerised posturography, specifically F2-F4 sway, is effective in identifying balance impairment and increased fall risk in individuals with T2DM, especially those with DPN.
- vHIT-detectable vestibular dysfunction appears to play a limited role in falls within this population.
- Postural instability, rather than vestibular deficits, is a key contributor to fall risk in T2DM patients.
