Heading for a Fall: Correlation Between LE Sensory Status, Balance and Fall Risk in Individuals with DM Type 2

OBJECTIVE. To determine the relationship between LE sensory integrity, balance status and fall risk in individuals with DM type 2. BACKGROUND. LE peripheral neuropathy including loss of sensation and proprioception is common in individuals with DM type 2, and can result in balance impairment and fall risk. Although the American Diabetes Association (ADA) recommends sensory testing, it does not recommend regular balance testing. METHODS. 16 subjects ages 44-83 participated. Range of time from diagnosis was 1 to 40 years with most recent HgA1C levels ranging from 6-12.2. Standardized bilateral LE proprioceptive testing of the great toes and ankles, monofilament testing of plantar foot surfaces, Romberg, Sharpened Romberg, and Functional Reach were performed. RESULTS. Although only 9/16 subjects demonstrated peripheral neuropathy, all sixteen demonstrated balance impairment and fall risk. CONCLUSIONS. In this study, all subjects demonstrated balance impairment and fall risk regardless of sensory status or age. The ADA has not included balance and fall risk assessment in their recommendations for managing individuals with DM type 2. Based on these preliminary findings, by addressing balance impairment and fall risk early in the disease course through appropriate therapies, falls may be prevented or the consequences ameliorated if or when sensory loss may develop. GRANTS. No grants or funding were used in the completion of this study.