ABSTRACT
Background & objectives: Diabetic peripheral neuropathy (DPN) is a major complication of type 2 diabetes and have long term complications on the postural control of the affected population. The objectives of this study were to evaluate postural stability in patients with DPN and to examine correlation of Michigan Neuropathy Screening Instrument (MNSI) with duration of diabetes, age and postural stability measures. Methods: Participants were included if they had clinical neuropathy which was defined by MNSI. Sixty one patients gave their consent to participate in the study and were evaluated on posturography for postural stability measures in four conditions. Repeated measures of analysis of variance (RANOVA) was used to analyze the changes in postural stability measures in different conditions. Results: An increase in mean value of postural stability measures was observed for velocity moment 20.4±1.3, 24.3±2.2, 42.3±20.7, 59±43.03, mediolateral displacement 0.21±0.10, 0.22±0.18, 0.03±0.11, 0.34±0.18, and anteroposterior displacement 0.39 ± 0.09, 0.45±0.12, 0.47±0.13, 0.51±0.20 from EO to EC, EOF, and ECF, respectively. There was a significant difference (P<0.05) in participants with DPN, with greater sway amplitude on firm and foam surface in all the conditions. Moderate correlation of MNSI with age (r=0.43) and postural stability measures were also observed. Interpretation & conclusions: Evaluation of postural stability in Indian DPN population suggests balance impairments on either firm and foam surfaces, with greater likelihood of fall being on foam or deformable surfaces among elderly adults with neuropathy (CTRI/2011/07/001884).
ABSTRACT
Objective: To find awareness regarding foot care in Indian population with diabetes in various parts of India. Materials and Method: A cross-sectional study design was used to perform a multicenter, national level survey from August, 2011 to February, 2012 in various parts of India. Descriptive analysis was done using Statistical Package for Social Sciences (SPSS) 16. Awareness levels for diabetic foot care were calculated as absolute frequencies and were reported as overall percentages. Spearman test was used to find the correlation for foot problems and diabetic foot care with socioeconomic status. Results: A total of 323 peoples were screened (there were 222 men and 101 women in the study with a mean age of 58.2 ± 8.6 years). 8.7% of men reported ulcer during the 1 st year of onset of diabetes, where as 8.3% of women were prone for ulcers in 16-20 years of diabetes, 56.4% of the population in urban area and 46.6% of the population in the rural area had been educated regarding foot care in diabetes. However, only 30.5% of population in urban areas and 9.7% of population in the rural areas knew about the importance of shoe selection in diabetes. Spearman's correlation was significant for foot problems with family income and educational status, P = 0.03 and P = 0.02 respectively. Conclusion: There is a need to bridge the disparity in awareness regarding diabetic foot management in Indian masses. More aggressive measures are required to implement current preventive foot care strategies in India.