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Hyperglycemia induces attention and gait deficits in diabetic mellitus patients

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Abstract

Aims

Patients with diabetes mellitus experience a large number of falls and bone fractures that are not related solely to complications of the disease. The purpose of our study was to determine whether transient hyperglycemia affects attentional functions and gait.

Methods

This was a case–control study. We asked 17 patients with type 1 or type 2 diabetes mellitus to perform three visual tests and one visual and auditory attention test (Phasic Alert A1-4 and A2-3, Go/No Go, Intermodal Comparison). Mean response time (ms) and total number of errors were assessed. Ten of the patients also performed a tandem gait test consisting of three steps. The total distance travelled (TDT, in mm) by the center of pressure was measured with a pressure-sensitive calibrated platform. Transient hyperglycemia was defined as blood glucose level greater than 13, 8 mmol/L at the time of the test. These same patients were retested 1–3 days later at a blood glucose level at least 5, 5 mmol/L lower than the initial values (T24-72h). Nineteen patients with diabetes mellitus were matched with the original participants and performed the same test under normoglycemic conditions.

Results

During transient hyperglycemia, the mean response time (ms) and the TDT were significantly longer. The mean response time for the four tests increased by 53, 5 ms (P < 0.001). There was no increase in the number of errors. The TDT of the center of pressure increased significantly by 102 mm (P < 0.001).

Conclusions

Transient hyperglycemia alters attention and gait in patients with diabetes mellitus.

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Author information

Authors and Affiliations

  1. Department of Internal medicine, Saint Pierre University Hospital, Brussels, Belgium

    L. Sattar

  2. Department of Internal Medicine, IRIS South Hospitals, Brussels, Belgium

    B. Renneboog

  3. Department of Internal Medicine, Cliniques Universitaires Erasme (ULB), 808 Route de Lennik, 1070, Brussels, Belgium

    G. Decaux

Authors
  1. L. Sattar
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  2. B. Renneboog
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  3. G. Decaux
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Corresponding author

Correspondence to G. Decaux.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The local ethics committee approved the study.

Informed consent

Written informed consent was obtained from each participant.

Additional information

Managed by Antonio Secchi.

Appendix

Appendix

Description of the attentional tests. The tests included the following:

The subject was placed 50 cm from the screen of a laptop (the screen measured 32 cm diagonally) and kept his or her finger just above the validation key (button 1).

Go/No Go (25 trials)

The subject had to react quickly and selectively to one class of stimuli appearing successively on the screen (squares with different textures, only two of which are targets).

Intermodal Comparison (20 trials)

The subject was required to press a key as soon as there was a match between a pitch (high or low) and the direction of the arrow (up or down) that appeared on the screen.

Phasic Alert (20 trials preceded by an auditory warning: series 2–3; 20 trials not preceded by an auditory warning: series 1–4)

The subject must press a key as soon as a cross appears on the screen. In the second set of trials, the appearance of a cross was preceded by a beep.

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Sattar, L., Renneboog, B. & Decaux, G. Hyperglycemia induces attention and gait deficits in diabetic mellitus patients. Acta Diabetol 54, 953–959 (2017). https://doi.org/10.1007/s00592-017-1034-6

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  • DOI: https://doi.org/10.1007/s00592-017-1034-6

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