Standing balance impairment in persons with type 2 diabetes is predicted by peripheral neuropathy and vestibulopathy

Introduction: The three main sensory complications of Type 2 Diabetes are diabetic peripheral neuropathy (DPN), diabetic retinopathy (DR), and diabetic vestibulopathy (DV). Current screening for these has been found to be insufficient, and balance testing may be a way to improve screening practices. This study aims to assess if the presence of sensory complications can be used to predict balance scores.

Methods: 52 participants with T2D were recruited for this study. Participants anthropometric measures, demographic, socioeconomic, and information related to the participants T2D were recorded. Participants completed the modified Clinical Test of Sensory Integration in Balance (mCTSIB) and scores were recorded. Bivariate analysis was conducted on all variables related to mCTSIB total balance scores. A multivariable linear regression model was created using mCTSIB total scores as the outcome and T2D sensory complications as the predictor while controlling for sex and age.

Results: Bivariate analysis revealed significant (p < 0.05) associations between mCTSIB total scores and T2D sensory complications, education, employment, annual income, and age. The final multivariate linear regression model was found to be significant (Adj R² = 0.45, p < 0.01). This model showed that those with DPN (β = 121.03 cm, CI = 77.71-164.35, p < 0.01) or DV (β: 60.65, CI = 5.17-116.13, p = 0.04) had significantly higher balance scores compared to those that did not have a sensory complication, adjusting for sex and age.

Conclusion: Sensory complications of T2D have the potential to predict balance scores and provides the first evidence that balance assessments may also be able to screen for DPN and DV.