Analysis reveals extent of physical disability caused by diabetes

by Barbara Hewitt on July 24, 2013

Analysis reveals extent of physical disability caused by diabetes

Analysis reveals extent of physical disability caused by diabetes

Older adults with diabetes are at least 50% more likely to have a physical disability than those without the condition, according to a new review of scientific research. Previous studies examining the risk of disability associated with diabetes have produced varying results, ranging from no association, to a doubling of risk. However, a new study is the first meta analysis to pool estimates taken from earlier studies which researchers says provides a more reliable estimate of the likely risk of disability associated with diabetes.

Led by Dr Anna Peeters and Dr Evelyn Wong, of the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, a team of researchers examined the scientific literature to identify more than 3,000 studies looking at the association between diabetes and disability. The researchers then narrowed this down to eventually include 26 studies in the meta analysis, after removing studies which were irrelevant or not suitable for inclusion.

Disability was defined in terms of both impaired mobility, and functional disability such as impaired ability to perform activities of daily living including bathing or eating, and instrumental activities of daily living such as using the phone, shopping, and using transport. Overall, the analysis showed that people with diabetes are at roughly 50% to 80% increased risk of physical disability, compared to people without diabetes. Although the study did not differentiate between type 1 and type 2 diabetes, the authors noted that the majority of studies included in the analysis were based on studies of people aged over 65 years among whom type 2 diabetes was predominant.

‘The reasons why diabetes is associated with physical disability are still unclear, although several mechanisms have been suggested. It’s possible that the high blood glucose concentrations experienced by people with diabetes might lead to chronic muscle inflammation, eventually resulting in physical disability, and some studies have shown that diabetes is associated with rapid and worsening muscle wasting,’ said Dr Peeters.

Quote from DiabetesForum.com : ““We are now trying to find a way to restore Neu1 levels and function in diabetes. If we can remove sialic acid residues from the cell surface, this will force the insulin receptor do its job of absorbing blood sugar properly. This could give doctors an opportunity to reduce the use of insulin therapy, and might help to reduce the diabetes epidemic, says Dr. Pshezhetsky.”

‘The complications associated with diabetes, such as heart disease, stroke, and kidney disease, can all result in disability. As the world’s population ages, and diabetes becomes more common, it seems clear that we will see an increased need for disability related health resources, which health systems around the world need to be prepared for,’ she added.

Dr Edward Gregg, of the Center for Disease Control and Prevention, in Atlanta, United States said that the new analysis focuses on studies of older people in higher income countries, because there is less quality research available outside these groups.

Writing in The Lancet Diabetes & Endocrinology where the research was published, he pointed out that diabetes often causes more relative damage in middle age than in older age so more research is needed into other age groups. ‘In view of the fact that the greatest increase in diabetes cases in low income and middle income countries are expected in middle aged adults, and that a large prevalence of disability could have damaging health and economic implications, more thorough examination of function across the full age spectrum of adults is also needed,’ he explained.


The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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