Postural Instability and Fall Risk in Type 2 Diabetes: A Cross-Sectional Study Using Posturography and Video Head Impulse Test

To investigate vestibular function, postural stability, and fall risk in individuals with type 2 diabetes mellitus (T2DM) with and without diabetic polyneuropathy (DPN), compared with healthy controls.

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

Audiologists and vestibular specialists should consider vestibular function testing in patients with type 2 diabetes, particularly those with known diabetic complications, as this population shows measurable postural instability and elevated fall risk.

✦ Why It Matters ✦

Demonstrating objectively measurable vestibular deficits and fall risk in type 2 diabetes strengthens the case for integrating vestibular screening into diabetes multidisciplinary care pathways.

✦ Key Points ✦

01Cross-sectional study using posturography and video head impulse test (vHIT) in type 2 diabetes patients.
02Vestibular dysfunction and postural instability were more prevalent in patients with diabetic complications.
03vHIT findings suggest semi-circular canal dysfunction contributing to imbalance.
04Fall risk was elevated in the diabetic group, particularly those with peripheral neuropathy or other complications.
05Cross-sectional design precludes causal conclusions about diabetes causing vestibular damage.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Type 2 diabetes patients, especially those with complications, show significant postural instability and elevated fall risk on posturography.

studysupported

Video head impulse test reveals vestibular canal dysfunction in type 2 diabetes patients.

studypartially supported

✦ Research metadata ✦

PMID: 42562201
DOI: 10.1016/j.apmr.2026.07.028.
Journal: Archives of Physical Medicine and Rehabilitation
Publication type: research_article
Evidence level: 3
Population: Adults with type 2 diabetes mellitus, with and without diabetic complications
Intervention: Posturography and video head impulse test (vHIT) assessment
Comparator: Type 2 diabetes patients without complications (and/or healthy controls)

Primary outcomes

Postural stability measures via posturography; Vestibular function via video head impulse test; Fall risk assessment

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