Peripheral neuropathy, decreased muscle strength and obesity are strongly associated with walking in persons with type 2 diabetes without manifest mobility limitations.
OBJECTIVE
We evaluated the associations of diabetic complications and underlying pathology with daily walking activity in type 2 diabetic patients without manifest mobility limitations.


METHODS
100 persons with type 2 diabetes (mean age 64.5 ± 9.4 years) were studied. Persons with manifest mobility limitations were excluded. Possible determinants measured: peripheral neuropathy, neuropathic pain, peripheral arterial disease, cardiovascular disease, decreased muscle strength (handgrip strength), BMI, depression, falls and fear of falling. Walking activity was measured during one week with a pedometer. Functional capacity was measured with the 6 min walk test, the timed "up and go" test and a stair climbing test.


RESULTS
prevalence of neuropathy (40%) and obesity (53%) was high. Persons took a median of 6429 steps/day. In multivariate regression analysis, adjusted for age and sex, neuropathy was associated with a reduction of 1967 steps/day, decreased muscle strength with 1782 steps/day, and an increase in BMI of 1 kg/m(2) with a decrease of 210 steps/day (all p<0.05). Decreased muscle strength and BMI, but not neuropathy, were associated with outcome of functional capacity tests in multiple regression analysis.


CONCLUSIONS
peripheral neuropathy, decreased muscle strength and obesity are strongly associated with walking in persons with type 2 diabetes without manifest mobility limitations.
van Sloten
Thomas T
TT
Dept. of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands. t.vansloten@student.maastrichtuniversity.nl
Savelberg
Hans H C M
HH
Duimel-Peeters
Inge G P
IG
Meijer
Kenneth
K
Henry
Ronald M A
RM
Stehouwer
Coen D A
CD
Schaper
Nicolaas C
NC
D000368:Aged; D000375:Aging; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000150:complications / Q000503:physiopathology*; D005260:Female; D018737:Hand Strength; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D018908:Muscle Weakness / Q000150:complications / Q000503:physiopathology*; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D015995:Prevalence; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires; D016138:Walking
D000959:Antihypertensive Agents