LINKS BETWEEN DIABETIC NEUROPATHY, OBESITY AND GAIT ABNORMALITIES

Diabetic neuropathy (DN) is microvascular complication associated with type 2 diabetes mellitus. The incidences of DN have increased with leaps and bounds due to increased prevalence of hyperglycemia. Common pathways underlie obesity, diabetes and gait; such as oxidative stress in mitochondrial dysfunction and inflammations. Obesity, disturb gait pattern, inadequate control of posture, high pressure on lower extremities and decrease in amount of bone mineral density, leads to increased incidences of bone fractures and injuries that show critical links with diabetic neuropathy. Obesity causes alterations in autonomic nervous system with prompt imbalances in sympathetic-parasympathetic activity, while alterations in the sensory-somatic nervous system may cause peripheral polyneuropathy which is a general complication in diabetic obese patients. Gait is a series of movements that shows propulsion of human skeleton, from heel-strike to heel-strike. Gait functions and balance are impaired in many of the neural disorders in which DN is the most common. DN includes a focal and multifocal neuropathy, sensorimotor polyneuropathy etc, which attributes to metabolic and micro-vessel changes caused by hyperglycemia and obesity like complication, resulting in muscle weakness and nerve pain. So many drugs are also available in market such as pregabalin, gabapentin, etc that invade the painful neuropathic pain but failed to treat the abnormal gait. Evidence on the effectiveness of conventional interventions for restoration of balance is limited in case diabetic neuropathy. This review discusses the link between obesity, diabetic neuropathy and gait abnormalities.