Evaluation of postural instability in IDDM patients: relationship with staging of diabetic peripheral neuropathy

ABSTRACT

The objective of this study was to use posturography to assess control of balance under static and dynamic conditions in patients with insulin dependent diabetes mellitus [IDDM], and to investigate relationship between the severity of IDDM peripheral neuropathy [PN] and postural stability. Computerized dynamic posturography [CDP] was used to assess postural stability and to investigate its relationship with staging of PN using sensory Organization Test [SOT]. Sixty IDDM patients were included in the study. According to the clinical and electrophysiological evaluation, patients were divided into four groups severe, moderate, mild and absent neuropathy. Patients with absent neuropathy were taken as controls for other groups. SOT showed significant dysfunction of somatosensory function of type two diabetic patients with peripheral neuropathy. Posturographic parameters [Dynamic test conditions SOT4, SOT5, SOT6 and Composite Equilibrium score [ES] were all significantly impaired in IDDM patients with PN. ES also showed a direct relationship to the severity of neuropathy. Posturographic study allows a disclosure of the failure of postural control in IDDM patients with PN even in the absence of clinical evidence of postural instability