title: Standing balance and trunk position sense in impaired glucose tolerance (IGT)-related peripheral neuropathy.
abstract: Type 2 diabetes mellitus (T2DM) and pre-diabetes or impaired glucose tolerance (IGT) affect a large segment of the population. Peripheral neuropathy (PN) is a common complication of T2DM, leading to sensory and motor deficits. While T2DM-related PN often results in balance- and mobility-related dysfunction which manifests as gait instability and falls, little is known about balance capabilities in patients who have evidence of PN related to IGT (IGT-PN). We evaluated patients with IGT-PN on commonly-used clinical balance and mobility tests as well as a new test of trunk position sense and balance impairment, trunk repositioning errors (TREs). Eight participants aged 50-72 years with IGT-PN, and eight age- and gender-matched controls underwent balance, mobility and trunk repositioning accuracy tests at a university neurology clinic and mobility research laboratory. Compared to controls, IGT-PN participants had as much as twice the magnitude of TREs and stood approximately half as long on the single leg balance test. People with IGT-PN exhibit deficits in standing balance and trunk position sense. Furthermore, there was a significant association between performance on commonly-used clinical balance and mobility tests, and electrophysiological and clinical measures of neuropathy in IGT-PN participants. Because IGT-related neuropathy represents the earliest stage of diabetic neuropathy, deficits in IGT-PN participants highlight the importance of early screening in the dysglycemic process for neuropathy and associated balance deficits.
authors.affiliation: Department of Health Care Sciences, Wayne State University, Detroit MI, USA. agoldberg@wayne.edu
authors.forename: Allon
authors.initials: A
authors.lastname: Goldberg
authors.forename: James William
authors.initials: JW
authors.lastname: Russell
authors.forename: Neil Burton
authors.initials: NB
authors.lastname: Alexander
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000453:epidemiology; D004856:Postural Balance / Q000502:physiology*; D011187:Posture; D013997:Time Factors