Factors Contributing to Postural Sway in Patients with Diabetes in an In-Hospital Education Program

Abstract

Objective: We investigated the effect of polyneuropathy, nephropathy, and retinopathy on postural sway in patients with poorly controlled diabetes mellitus (DM) who were hospitalized for DM education. We also investigated the relationship between postural sway and hearing disturbances. Methods: We included 50 subjects who were hospitalized for the purpose of DM education. Mean age was 57.2 years, mean HbA 1c was 9.4%, and mean DM duration was 11.1 years. Renal function, retina condition, and nerve conduction were evaluated in relation to DM complications (nephropathy, retinopathy, and neuropathy). Static posturography was performed to assess DM-related postural sway. Nerve conduction studies were used to obtain information on the condition of peripheral nerves. Pure-tone audiometry was measured. Stepwise multiple linear regression was used to assess DM-related factors that affected postural sway. Results: Deterioration of median nerve compound muscle action potential (CMAP) amplitude, tibial nerve CMAP conduction velocity, and peroneal nerve CMAP latency were associated with deterioration of postural sway. Deterioration of hearing in the worse ear was also associated with postural sway. Conclusion: In patients with poorly controlled DM, postural sway was particularly associated with deterioration of motor nerve conduction study parameters represented by median nerve CMAP amplitude, tibial nerve CMAP conduction velocity, and peroneal nerve CMAP latency. A link between diabetic polyneuropathy, diabetes-related postural sway, and diabetes-related hearing loss was recognized.