Young type 1 diabetes subjects sway more than healthy persons when somatosensory system is challenged in static standing postural stability tests

Abstract

In type 1 diabetes, it is important to prevent diabetes-related complications and postural instability may be one clinically observable manifestation early on. This study was set to investigate differences between type 1 diabetics and healthy controls in variables of instrumented posturography assessment to inform about the potential of the assessment in early detection of diabetes-related complications. Eighteen type 1 diabetics with no apparent complications (HbA1c = 58 ± 9 mmol/L, diabetes duration = 15 ± 7 years) and 35 healthy controls underwent six 1-min two feet standing postural stability tests on a force plate. Study groups were comparable in age and anthropometric and performed the test with eyes open, eyes closed (EC), and EC head up with and without unstable padding. Type 1 diabetics exhibited greater sway (path length, p = 0.044 and standard deviation of velocity, p = 0.039) during the EC test with the unstable pad. Also, power spectral density indicated greater relative power (p = 0.043) in the high-frequency band in the test with EC head up on the unstable pad and somatosensory activity increased more (p = 0.038) when the unstable pad was added to the EC test. Type 1 diabetes may induce subtle changes in postural control requiring more active balancing when stability is challenged. Postural assessment using a portable easy-to-use force plate shows promise in detecting a diabetes-related decline in postural control that may be used as a sensitive biomarker of early-phase diabetes-related complications.