Autonomic, endothelial function and the analysis of gait in patients with type 1 and type 2 diabetes

Abstract

Ten control subjects and 20 subjects with type 1 and type 2 diabetes were examined to compare autonomic, endothelial function and gait characteristics while walking in a linear path and during turns. To measure deviations in gait, timing was recorded from foot sensors worn in the shoes and from accelerometers (2 axis) mounted on the head, shoulder, hips, knees and ankles, bilaterally. The results of the experiments showed that subjects with diabetes took additional steps when walking in a linear path and during turns. They also took significantly more time to walk a given distance (greater than 30%) than control subjects. Accelerometry data also revealed that there was an increase in flexion/extension and lateral movement at the major joints in the body. Joint movements at the hip, knee, ankle and shoulders showed a 50 and 100% increase in movement at the joints during gait for subjects with diabetes compared to control subjects. These findings suggest that individuals with type 1 and type 2 diabetes can have significant problems in both the timing and quality of gait. These impairments are likely secondary to dysfunction of the vestibular, somatosensory and autonomic system in diabetics. Data here showed at least a 50% impairment in local tissue blood flow and autonomic function in subjects in both type 1 and type 2 diabetes compared to control subjects.