Reduction of gait abnormalities in type 2 diabetic patients due to physical activity: a quantitative evaluation based on statistical gait analysis

The aim of this study is the objective assessment of gait abnormalities in diabetic patients and the quantification of the benefits of physical activity in improving the gait quality. Patients were equipped with foot-switches and knee goniometers and were asked to walk at their natural pace for 2.5 minutes. A statistical gait analysis was performed extracting from hundreds of strides the ‘atypical' cycles, i.e. the cycles which do not show the usual sequence of gait phases (heel contact, flat foot contact, push off, swing), the duration of the heel contact phase and the knee kinematics in the sagittal plane. A sample population of 27 non-neuropathic type 2 diabetic patients was examined before and after attending a light-intensity physical activity program that lasted four months. A fuzzy classifier was used to assign a score to the gait abnormalities of each patient in baseline conditions and after the program completion. More than 50% of the subjects reduced significantly their gait abnormalities and, on the average, the most frequent improvements were the reduction of atypical cycles and heel contact duration. Furthermore we found that, in basal conditions, the left side is more affected by gait abnormalities than the right one (P < 0.003

Quality of life and treatment satisfaction in adults with Type 1 diabetes: A comparison between continuous subcutaneous insulin infusion and multiple daily injections

Aims: The aim of this case-control study was to compare quality of life (QoL) and treatment satisfaction in adults with Type 1 diabetes (T1DM) treated with either continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). Methods: Consecutive patients aged between 18 and 55 years, and attending diabetes clinics for a routine visit, completed the Diabetes-Specific Quality-of-Life Scale (DSQOLS), the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the SF-36 Health Survey (SF-36). Case (CSII) and control subjects (MDI) were recruited in a 1 : 2 ratio. Results: Overall, 1341 individuals were enrolled by 62 diabetes clinics; 481 were cases and 860 control subjects. Cases had a longer diabetes duration and were more likely to have eye and renal complications. Age, school education, occupation and HbA1c were similar. Of control subjects, 90% followed glargine-based MDI regimens and 10% used NPH-based MDI regimens. On multivariate analysis, after adjusting for socioeconomic and clinical characteristics, scores in the following areas of the DSQOLS were higher in cases than control subjects: diet restrictions (β = 5.96; P &lt; 0.0001), daily hassles (β = 3.57; P = 0.01) and fears about hypoglycaemia (β = 3.88; P = 0.006). Treatment with CSII was also associated with a markedly higher DTSQ score (β = 4.13; P &lt; 0.0001) compared with MDI. Results were similar when CSII was compared separately with glargine- or NPH-based MDI regimens. Conclusions: This large, non-randomized, case-control study suggests quality of life gains deriving from greater lifestyle flexibility, less fear of hypoglycaemia, and higher treatment satisfaction, when CSII is compared with either glargine-based or NPH-based MDI regimens. © 2008 The Authors