Unsteady walking as a symptom in type 2 diabetes mellitus: independent association with depression and sedentary lifestyle and no association with diabetic neuropathy

Braz J Med Biol Res. 2018 Mar 26;51(5):e6605. doi: 10.1590/1414-431X20186605.

Abstract

The purpose of this study was to look at the determinants of the unsteady walking (UW) symptom in patients with type 2 diabetes mellitus (T2DM) by defining if UW and/or the Diabetic Neuropathy Symptoms Score (DNSS) are associated with positive scores in Beck's Depression Inventory (BDI) and with a positive Michigan Neuropathy Screening Instrument score (MNSI). We evaluated 203 T2DM patients without visible gait disturbances. They were divided into UW (+) and UW (-) or DNSS (+) and DNSS (-) according to symptoms. We found a prevalence of 48.3% for UW (+) and of 63% for DNSS (+) in our sample. In univariate analysis, the presence of UW was significantly associated with waist circumference (P=0.024), number of comorbidities (P=0.012), not practicing physical exercise (P=0.011), positive BDI score (P=0.003), presence of neuropathic symptoms by the MNSI questionnaire (P<0.001), and positive diabetic neuropathy screening by MNSI (P=0.021). In multivariate analysis, UW (used as a dependent variable) was independently associated with a positive BDI score (P<0.001; 95%CI=1.01-1.03), T2DM duration (P=0.023; 95%CI=1.00-1.03), number of co-morbidities (P=0.032; 95%CI=1.01-1.37), and a sedentary lifestyle (P=0.025; 95%CI=1.06-2.5). The UW symptom and a positive DNSS are more closely related to a positive score for depression than to presence of neuropathy in T2DM.

MeSH terms

  • Cross-Sectional Studies
  • Depression / psychology*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Neuropathies / complications*
  • Diabetic Neuropathies / physiopathology
  • Diabetic Neuropathies / psychology
  • Female
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Prevalence
  • Sedentary Behavior*
  • Sensation Disorders / etiology*
  • Severity of Illness Index
  • Walking / physiology*