Impaired Dynamic Postural Control in People with Diabetes: An Exploratory Cross-Sectional Study Using Computerized Dynamic Posturography (Bertec)

BACKGROUND: This study assessed static and dynamic postural control in individuals with type 1 (T1D) and type 2 diabetes (T2D) using Computerized Dynamic Posturography (Bertec), hypothesizing that diabetes, especially with diabetic peripheral neuropathy (DPN), leads to significant impairments in postural stability. METHODS: A total of 94 participants with diabetes (T1D: n=49, T2D: n=45) and 94 age- and sex-matched controls underwent postural assessments using the Sensory Organization Test (SOT) and Motor Control Test (MCT). The SOT evaluated sensory system contributions (somatosensory,visual, vestibular), while the MCT assessed postural recovery responses. RESULTS: Both T1D and T2D groups exhibited impaired SOT performance compared to controls (P < .05). Type 1 diabetes showed impaired visual function (P < .05), while both groups demonstrated poorer postural stability in conditions requiring vestibular input (P < .05) and slower MCT response times (10 of 14 abnormal, P < .05). T2D participants relied excessively on visual input (preference function: P < .05). No significant associations were detected between DPN, body mass index, Hemoglobin A1c (HbA1c), or diabetes duration with postural control impairments. CONCLUSION: Diabetes impairs postural control, particularly in conditions that rely heavily on vestibular and visual inputs, regardless of DPN. Advanced tools like Bertec reveal real-world deficits, highlighting the potential value of these findings in informing future fall-prevention strategies for individuals with diabetes.