medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2013-12-118-119medsovet-1174Research ArticleДИССЕРТАНТDISSERTANTВлияние дистальной полинейропатии на нарушение равновесия у больных сахарным диабетомThe effect of distal polyneuropathy on balance disorder in patients with diabetesФедороваО. С.FedorovaО. S.noemail@neicon.ruГурьеваИ. В.GurievaI. V.noemail@neicon.ruCтроковИ. А.StrokovI. A.noemail@neicon.ruФГБУ «Федеральное бюро медико-социальной экспертизы»РоссияFederal Bureau of Medical and Social Examination, MoscowRussian FederationПервый МГМУ им. И.М. СеченоваРоссияFederal Bureau of Medical and Social Examination, MoscowRussian FederationПервый МГМУ им. И.М. СеченоваРоссияFirst Moscow State Medical University named after I.M. SechenovRussian Federation201330122013012118119Copyright © Федорова О.С., Гурьева И.В., Cтроков И.А., 20132013Федорова О.С., Гурьева И.В., Cтроков И.А.Fedorova О.S., Gurieva I.V., Strokov I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1174

По данным различных авторов, распространенность сенситивной атаксии (вследствие нарушения проприоцептивной афферентации) у пациентов с сахарным диабетом (СД) составляет от 10 до 90% [1, 2]. Столь большой разброс данных в отдельных исследованиях позволяет предположить недостаточную изученность этого вопроса. P.R. Cavanagh с соавторами установил, что пациенты с СД и наличием дистальной симметричной сенсорно-моторной полинейропатии (ДПН) в 15 раз чаще получают повреждения при ходьбе (падения, переломы, вывихи лодыжки, порезы и ушибы), чем пациенты с СД без ДПН [3]. Brach J.S. с соавторами отмечал, что факторами, приводящими к нарушению равновесия у пациентов с СД, могут являться сенсорный дефицит, снижение силы мышц ног и поражение ЦНС [4]. В то же время нарушению равновесия у больных сахарным диабетом в результате дистальной полинейропатии уделяется гораздо меньше внимания, по сравнению с падениями вследствие автономной нейропатии и ортостатическим снижением давления [5].

According to various authors, the prevalence of sensitive ataxia (due to proprioceptive dysfunction) in patients with diabetes mellitus (DM) equals 10 to 90% [1, 2]. The great variability of data from different studies suggests that the question is understudied. P.R. Cavanagh et al. found that patients with DM and distal symmetric sensorimotor polyneuropathy (DPN) have walking injuries 15 times more often (falls, fractures, sprained ankle, cuts and bruises) than diabetic patients without DPN [3]. Brach J.S. et al. noted the following factors leading to balance disorders in patients with DM: sensory deficit, decreased leg muscle strength and lesions of the CNS [4]. At the same time, balance disorder in patients with diabetes resulting from distal polyneuropathy received has been given much less attention compared with falls caused by autonomic neuropathy and orthostatic hypotension [5].

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The authors declare that there are no conflicts of interest present.