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

• Main Authors: L.S. Dias, O.H. Nienov, C.F. Goelzer Neto, H. Schmid
• Format: Article
• Language: English
• Published: Associação Brasileira de Divulgação Científica 2018-03-01
• Series: Brazilian Journal of Medical and Biological Research
• Subjects: Diabetic neuropathy; Depression; Unsteady walking; Lifestyle
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2018000500613&lng=en&tlng=en

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.