Abstract

Diabetes is recognized to lead to a series of metabolic abnormalities in the body. These alterations will affect balance, body composition, and cardiovascular performance, heightening the risk of various medical complications. The problem is that the primary instruction for those with diabetes is to monitor glucose levels, paying very insufficient consideration to other fundamental factors and health profiles that could influence the quality of life in these individuals. Identify body composition, balance, and cardiovascular components in controlled type two diabetics compared to an age-matched control group. 15 participants with controlled type II diabetes without peripheral neuropathy (CT2DM) and 18 non-diabetic subjects control (CG) were recruited. Both groups had an age average of roughly 56 years old. The CT2DM subjects had an average A1c level of 6.7+/-0.5%. Body composition, cardiovascular, and balance data were collected, analyzed, and compared among groups. Minimal alterations in balance components, body composition and cardiovascular factors were identified in the CT2DM group aside from higher SBP values and decreased BBS scores contrasted to the CG group. We can attribute the analogous outcomes in both groups to CT2DM participants managing their diabetes effectively. Our examination has prompted us to establish that the cardiovascular and balance components in middle-aged Latinx-Hispanic participants with CT2DM are proportionate to CG subjects because of effectiveness in dealing with diabetes. Further, we encourage establishing more age appropriate and complex assessment tools to identify early adaptations caused by diabetes.

Keywords

Controlled Diabetes, Balance, Health Profile, Diabetes Management,

References

  1. Centers for Disease Control and Prevention. (2019a). Type 2 Diabetes. https://www.cdc.gov/diabetes/basics/type2.html
  2. Centers for Disease Control and Prevention. (2019b). Hispanic/Latino Americans and Type 2 Diabetes. https://www.cdc.gov/diabetes/library/features/hispanic-diabetes.html
  3. Centers for Disease Control and Prevention. (2019c). CDC Releases First National Estimates on Diabetes within Hispanic and Asian Populations in the US [Press release]. https://www.cdc.gov/media/releases/2019/p1220-diabetes-estimate.html
  4. Y.J. Cheng, A.M. Kanaya, M.R.G. Araneta, S.H. Saydah, H.S. Kahn, E.W. Gregg, W.Y. Fujimoto, G. Imperatore, Prevalence of Diabetes by Race and Ethnicity in the United States, 2011-2016, JAMA, 322(24) (2019) 2389–2398.
  5. Office of Minority Health. (2019). Diabetes and Hispanic Americans. Office of Minority Health, U.S. Department of Health and Human Services. Retrieved from: https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=63
  6. F.R. Marino, D.M. Lessard, J.S. Saczynski, D.D. McManus, L.G. Silverman‐Lloyd, C.M. Benson, M.J. Blaha, M.E. Waring, Gait speed and mood, cognition, and quality of life in older adults with atrial fibrillation, Journal of the American Heart Association, 8(22) (2019).
  7. M. Vongsirinavarat, W. Mathiyakon, R. Kraiwong, V. Hiengkaew, Fear of falling, lower extremity strength, and physical and balance performance in older adults with diabetes mellitus, Journal of Diabetes Research, (2020).
  8. T. Ghanavati, M.J.S. Yazdi, S. Goharpey, A. Arastoo, Functional balance in elderly with diabetic neuropathy, Diabetes Research and Clinical Practice, 96(1) (2012) 24-28.
  9. K.H. Cho, S.K. Bok, Y-J. Kim, S.L. Hwang, Effect of lower limb strength on falls and balance of the elderly, Annals of Rehabilitation Medicine, 36(3) (2012) 386–393.
  10. Y. Yang, X. Hu, Q. Zhang, R. Zou, Diabetes mellitus and risk of falls in older adults: a systematic review and meta-analysis, Age Ageing, 45(6) (2016) 761-767.
  11. J.K. Richardson, S.B. Thies, T.K. DeMott, J.A. Ashton-Miller, A comparison of gait characteristics between older women with and without peripheral neuropathy in standard and challenging environments, Journal of the American Geriatrics Society, 52(9) (2004) 1532-7.
  12. L. Allet, S. Armand, R.A. de Bie, A. Golay, D. Monnin, K. Aminian, J.B. Staal, E.D. de Bruin, The gait and balance of patients with diabetes can be improved: a randomised controlled trial, Diabetologia, 53(3) (2010) 458–466.
  13. J.B. Dingwell, J.P. Cusumano, D. Sternad, P.R. Cavanagh, Slower speeds in patients with diabetic neuropathy lead to improved local dynamic stability of continuous overground walking, Journal of Biomechanics, 33(10) (2000) 1269-77.
  14. J. Petrofsky, S. Lee, S. Bweir, Gait characteristics in people with type 2 diabetes mellitus, European Journal of Applied Physiology, 93(5-6) (2005) 640-7.
  15. Y. Agrawal, J.P. Carey, C.C. Della Santina, M.C. Schubert, L.B. Minor, Diabetes, vestibular dysfunction, and falls: Analyses from the National Health and Nutrition Survey, Otology & Neurotology, 31 (2010) 1445-1450.
  16. C. Bonnet & C. Ray, Peripheral neuropathy may be not the only fundamental reason explaining increased sway in diabetic individuals, Clinical Biomechanics, 26 (2011) 699-706.
  17. M.S. Maurer, J. Burcham, H. Cheng, Diabetes mellitus is associated with an increased risk of falls in elderly residents of a long-term care facility, The Journals of Gerontology, 60A(9) (2005) 1157-1162.
  18. M.G. Rosario, N.D. Mbue, A. Jose, Temporo-spatial gait adaptations while walking on different surfaces in Latino-Hispanic adults with controlled type II diabetes, Journal of Human Sport and Exercise, in press (2020).
  19. J.S. Wrobel & B. Najafi, Diabetic foot biomechanics and gait dysfunction, Journal of Diabetes Science and Technology, 4(4) (2010) 833-45.
  20. Centers for Disease Control and Prevention (CDC). Prevalence of overweight and obesity among adults with diagnosed diabetes--United States, 1988-1994 and 1999-2002, MMWR Morbidity and Mortality Weekly Report, 53(45) (2004) 1066-8.
  21. A.A. Gonzalez-Zacarias, A. Mavarez-Martinez, C.E. Arias-Morales, N. Stoicea and B. Rogers, Impact of demographic, socioeconomic, and psychological factors on glycemic self-management in adults with type 2 diabetes mellitus, Frontiers in Public Health, 4 (2016) 195.
  22. D. Aronson & E.J. Rayfield, How hyperglycemia promotes atherosclerosis: molecular mechanisms, Cardiovascular Diabetology. 1(1) (2002).
  23. National Heart, Lung, and Blood Institute. (2020). Atherosclerosis. U.S. Department of Health and Human Services. Retrieved from: https://www.nhlbi.nih.gov/health-topics/atherosclerosis
  24. American Diabetes Association. (2020). Conquer high blood pressure. https://www.diabetes.org/diabetes-risk/prevention/high-blood-pressure
  25. J. Stewart, K. Brown, D. Kendrick, J. Dyas, Understanding of blood pressure by people with type 2 diabetes: a primary care focus group study, British Journal of General Practice, 55(513) (2005) 298-304.
  26. X. Zhang, X.O. Shu, Y.B. Xiang, G. Yang, H. Li, H. Cai, Y.T. Gao, W. Zheng, Resting heart rate and risk of type 2 diabetes in women, International Journal of Epidemiology, 39(3) (2010) 900–906.
  27. G.S. Hillis, M. Woodward, A. Rodgers, C.K. Chow, Q. Li, S. Zoungas, A. Patel, R. Webster, G.D. Batty, T. Ninomiya, G. Mancia, N.R. Poulter, J. Chalmers, Resting heart rate and the risk of death and cardiovascular complications in patients with type 2 diabetes mellitus, Diabetologia, 55(5) (2012) 1283-90.
  28. Shirley Ryan Ability Lab. Berg balance scale. (2020). AbilityLab. Retrieved from: https://www.sralab.org/rehabilitation-measures/berg-balance-scale
  29. T.M. Steffen, T.A. Hacker, L. Mollinger, Age- and gender-related test performance in community dwelling elderly people: six-minute walk test, berg balance scale, timed up & go test, and gait speeds, Physical Therapy, 82(2) (2002) 128-137.
  30. D.R. Ceci, Silva MD da, É.B. Gomes, H.A. Pinheiro, Analysis of balance in diabetic patients through the F-scan system and Berg's Balance Scale, Fisioterapia em Movimento, 26(1) (2013) 55-61.
  31. A. Behrman, K.E. Light, S.M. Flynn, M.T. Thigpen, Is the functional reach test useful for identifying falls risk among individuals with Parkinson’s disease, Archives of Physical Medicine and Rehabilitation, 83(4) (2002) 538-42.
  32. S.D. Jernigan, P.S. Pohl, J.D. Mahnken, P.M. Kluding, Diagnostic accuracy of fall risk assessment tools in people with diabetic peripheral neuropathy, Physical Therapy, 92(11) (2012) 1461–1470.
  33. J.E. Williams, B. Helsel, B. Nelson, R. Eke, Exercise considerations for type 1 and type 2 diabetes, ACSM's Health & Fitness Journal, 22(1) (2018) 10-16.
  34. S.R. Colberg, R.J. Sigal, B. Fernhall, J.G. Regensteiner, B.J. Blissmer, R.R. Rubin, L. Chasan-Taber, A.L. Albright, B. Braun, Exercise and type 2 diabetes: the american college of sports medicine, & american diabetes association: joint position statement, Diabetes care. 33(12) (2010) e147–e167.
  35. M.G. Rosario, A Hyder, E. Orozco, J.G. Vélez, C.L. Quiñones, F. Bayron, Evaluating static postural control in subjects with controlled-diabetes mellitus II, Journal of Human Sport and Exercise. 15(2) (2020) 344-354.
  36. L. Allet, S. Armand, R.A. Bie, Z. Pataky, K. Aminian, F.R. Herrmann, E.D. de Bruin, Gait alternations of diabetic patients while walking on different surfaces, Gait & Posture. 29(3) (2009) 488-93.