Journal of Health Wellness and Community Research · Mar 15, 2026
Association of Glycemic Status with Functional Balance and Fall Risk in Older Adults with Type 2 Diabetes Mellitus with and Without Diabetic Neuropathy: A Cross-Sectional Study
By Butt F, Javed S, Ulfat N et al.
Background: Type 2 diabetes mellitus and diabetic peripheral neuropathy may impair balance and mobility, but the association between glycemic status and functional performance according to neuropathy status remains unclear. Objective: To determine the associations of HbA1c and random blood glucose with functional balance and fall-risk-related mobility in adults with T2DM with and without diabetic peripheral neuropathy. Methods: This cross-sectional correlational study was conducted from March 2024 to February 2025 at healthcare and community settings in the twin cities of Pakistan. A total of 182 participants aged ≥50 years with T2DM for >5 years were included, with 91 participants in each neuropathy group. Glycemic status was assessed using HbA1c and random blood glucose; balance and mobility were assessed using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. Between-group comparisons, Pearson correlations, Fisher r-to-z comparisons, and Holm adjustment for multiple testing were applied. Results: Participants with neuropathy had higher HbA1c (8.40±1.97% vs 6.98±1.76%; p<0.001), higher random glucose (316.17±110.66 vs 259.67±91.94 mg/dL; p<0.001), and lower BBS scores (34.30±11.05 vs 38.28±9.26; p=0.009). TUG times did not differ significantly (15.99±9.09 vs 13.75±8.08 seconds; p=0.081). No within-group glycemic–functional correlation remained significant after Holm adjustment. However, the HbA1c–BBS correlation differed between neuropathy groups (r=0.12 vs −0.26; Fisher z=2.57; Holm-adjusted p=0.041). Conclusion: Glycemic measures were not consistently associated with functional balance or mobility, although the relationship between HbA1c and balance differed according to neuropathy status. These findings support considering neuropathy and other functional determinants when evaluating balance in adults with T2DM