Diabetes Linked to Decreased Mobility

Patients with diabetes and lower extremity disease have an increased risk of mobility limitation in adults 40 years of age and older.

An analysis of 1999 to 2002 data from the National Health and Nutrition Survey (NHANES) for adults aged 40 years and older has revealed a significantly higher prevalence of mobility limitation in those diagnosed with diabetes (27% vs 16%; Odds Ratio [OR] = 2.0; Confidence Interval [CI], 1.4 – 3.0), compared with non-diabetics.

Lower extremity disease (LED; peripheral artery disease and peripheral neuropathy) was also associated with a significantly increased likelihood of limited mobility (26% vs 15%; OR = 2.3; CI, 1.7 – 2.9).

Furthermore, diabetes and LED had an additive effect on the risk for mobility limitation; adults with both conditions had an almost 3-fold increase in risk, compared with those having neither (39% vs 14%).

The most frequently reported mobility limitations were related to patients’ ability to walk a quarter mile and walk up 10 steps without resting.

Among those with diabetes and LED, 33% of patients reported difficulty with these tasks, and 6% reported difficulty walking from one room to another on the same level. This is the most serious form of limitation and can impair an individual’s ability to perform activities of daily living.

The CDC notes that LED and its health consequences (chronic foot/leg ulcers, amputations, and mobility limitations) is gaining importance as a public health concern due to the increasing prevalence of diabetes as the U.S. population ages.

In addition, many diabetics do not receive the recommended proper foot care and other preventive measures intended to reduce their risk for LED. According to an analysis of 2003 data, only 67% of diabetics receive a yearly foot exam, although 88% report having an annual doctor visit.

Additional information regarding LED and diabetic foot care may be obtained online at https://www.ndep.nih.gov/campaigns/feet/feet_overview.htm.
MMWR. 2005;54; 1177-1200.

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FACT:
Similar Mortality Risks in Diabetes and Those with Heart Disease: A group of researchers in Finland compared the risk of mortality as a result of coronary heart disease (CHD) in patients with type 2 diabetes and non-diabetic patients with prior myocardial infarction (MI) or evidence of CHD. The researchers found that the risk of CHD death was similar in diabetic patients with no prior MI and non-diabetic patients with prior MI. Diabetic patients with no evidence of prior CHD had a greater risk of CHD death than non-diabetic patients with evidence of prior CHD. This risk was particularly increased in women. Similar results were found for total and cardiovascular mortality. The researchers concluded that diabetes without prior MI and prior MI without diabetes conveyed a similar risk of CHD death. Diabetic patients with no evidence of prior CHD had a greater risk than non-diabetic patients with evidence of prior CHD, particularly in women. Diabetes Care 2005;28:2901-7

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