Diabetes and Sensory Processing

Sensory processing plays a crucial role in how individuals, particularly those with diabetes, interpret information from their surroundings and their internal bodily signals. This complex process involves recognizing and integrating various types of sensory inputs, including sights, sounds, touches, tastes, and smells. For people living with diabetes, effective sensory processing is essential in managing their condition and navigating daily routines. For example, subtle changes in temperature, the ambiance created by music, or smells of food can significantly influence not only their mood but also their blood sugar levels and overall sense of well-being. For individuals with diabetes, daily activities, such as navigating crowded spaces, sharing meals, or communicating their health needs to others, are related to their sensory processing abilities. These activities can be influenced by how they perceive and respond to sensory stimuli in their environment. Some individuals may have heightened sensitivity to these stimuli, which can create both advantages and challenges. On the one hand, increased sensitivity can enhance awareness, allowing individuals to make more informed decisions regarding their food choices and health management. But, this heightened awareness can also lead to overwhelming experiences due to sensory overload, causing stress and distraction.

The challenges faced by those with diabetes are exacerbated by external factors that can complicate sensory processing. Social interactions, for instance, can be particularly daunting. The stress of managing diabetes combined with the pressures of engaging in social scenarios can lead to heightened discomfort. Sensory processing difficulties, with the psychological demands of living with a chronic condition, can create increased stress levels, anxiety, and feelings of isolation (Acevedo et al., 2023). Sensory processing sensitivity (SPS) is a genetically influenced trait that can further complicate the experience of managing diabetes. Characterized by an increased awareness of sensory stimuli and emotional experiences, SPS can impact how individuals navigate their condition. Those with SPS may approach their diabetes management with heightened caution, often taking more time to make decisions because their active behavioral inhibition system (BIS) heightens their awareness of potential risks in their environment (Kenemore et al., 2023). This hyperawareness can lead to increased feelings of anxiety and stress, especially when facing health-related challenges or engaging in social interactions. As a result, individuals may find themselves feeling frustrated or isolated, as the very aspects of their sensory processing that make them unique can also amplify their struggles.

Understanding the interplay between SPS and diabetes emphasizes the need for tailored support and personalized strategies that empower individuals to effectively manage their health while embracing their unique sensitivities (Goldberg et al., 2018). By acknowledging the challenges that come with SPS, caregivers and healthcare providers can tailor their approaches to better suit the needs of individuals with diabetes. This could involve creating environments that reduce sensory overload, providing emotional support, or encouraging mindfulness practices that help individuals navigate their sensory experiences more easily.

Diabetes and Cortical Processing with Walking

Walking is a complex activity that depends on intricate processing in the brain and effective communication with the spinal cord. As we move, our brain interprets a wide array of sensory information, integrating signals from our vision, proprioception, and vestibular systems to maintain balance and direction. This process involves several cortical areas, particularly the motor cortex, which plans and executes movement, and the sensory cortex, which processes feedback from our body and environment.

For individuals with diabetes, the coordination required for walking can be significantly affected by complications arising from the condition. One of the primary issues is diabetic neuropathy, a form of nerve damage that disrupts the delicate pathways responsible for sensation and motor control (Holtzer et al., 2018;  Paul et al., 2009). This disruption hampers the brain’s ability to receive and process crucial sensory information, which is essential for smooth and coordinated movement. Consequently, individuals experiencing diabetic neuropathy may have reduced sensitivity in their feet and legs, making it difficult to detect the ground beneath them. This loss of sensation complicates their ability to gauge their position and maintain balance, turning the simple act of walking, often taken for granted, into a challenging endeavor and increasing the risk of falls and injuries.

Fluctuating blood sugar levels also play a critical role in one’s ability to walk safely, affecting both cognitive function and motor skills. When blood sugar drops too low, a condition known as hypoglycemia occurs, leading to symptoms such as confusion, weakness, and dizziness. These effects can severely impair focus and spatial awareness, making navigation challenging and heightening the risk of falls or accidents (Petrofsky et al., 2005). Safe walking requires not just physical strength but also mental clarity and coordination, both of which can suffer when blood sugar is low. On the other hand, high blood sugar levels, or hyperglycemia, can result in fatigue and lethargy. This lack of energy makes physical movement feel more strenuous and can slow response times, further affecting a person’s ability to walk safely. The combined effects of tiredness and reduced alertness can undermine balance and coordination, making it difficult to react quickly to potential hazards in the environment (Allet et al., 2010).

For individuals with diabetes, the intricate interplay of cortical processing, blood sugar regulation, and motor control presents unique challenges that can greatly impact their ability to walk safely and effectively.

Motor Output and Physical Activity in Individuals with Diabetes

Motor output, the ability of the nervous system to activate muscles to move, is significantly affected in individuals with diabetes, particularly those with long-standing or poorly managed disease. Diabetes, especially Type 2, can lead to peripheral neuropathy, a condition where nerves in the extremities become damaged due to prolonged high blood sugar levels. This damage impairs the transmission of signals from the brain and spinal cord to the muscles, resulting in reduced coordination, slower reflexes, and diminished fine motor control (Muramatsu, 2020). These deficits in motor output can greatly impact daily functioning and quality of life for diabetic individuals.

Peripheral neuropathy also contributes to muscle weakness and atrophy, especially in the lower limbs (Bodman et al., 2025).  The lack of proper neural stimulation causes muscles to shrink and weaken over time, making activities like walking, climbing stairs, or even standing for long periods increasingly difficult. In addition, the sensory deficits often associated with neuropathy, such as numbness and reduced proprioception, further worsen motor impairments, increasing the risk of falls and injuries. As a result, maintaining mobility and independence becomes a growing concern in the diabetic community.

Changes in motor output can significantly impact physical activity levels, which are essential for the management of diabetes. Engaging in regular exercise is vital not only for improving insulin sensitivity but also for maintaining blood sugar control and enhancing cardiovascular health. These benefits are particularly crucial, as individuals with diabetes face a heightened risk of heart disease and other metabolic complications. However, for many people, motor impairments can create substantial barriers to participating in physical activity. This may include issues such as reduced strength, coordination, or balance, which can discourage individuals from engaging in exercise programs (Muscle Strength in Type 2 Diabetes | Diabetes | American Diabetes Association, n.d.). As a result, a concerning feedback loop can emerge: reduced physical activity leads to further declines in motor function, which, in turn, increases metabolic health issues, including worsening blood sugar levels and increased insulin resistance.

To mitigate the effects of impaired motor output, a multidisciplinary approach is often needed. Physical therapy can help preserve muscle strength and coordination, while occupational therapy can assist individuals in adapting daily tasks to their capabilities. Tight glycemic control, proper foot care, and early screening for neuropathy are essential in slowing the progression of motor decline (Motor Dysfunction in Diabetes, n.d.). Increasing awareness of these issues within the diabetic community and among healthcare providers can lead to better support systems and outcomes for those affected.

References 

Acevedo, B. P., Aron, E. N., Aron, A., Cooper, T., & Marhenke, R. (2023). Sensory processing sensitivity and its relation to sensation seeking. Current Research in Behavioral Sciences, 4, 100100. https://doi.org/10.1016/j.crbeha.2023.100100

Allet, L., Armand, S., de Bie, R. A., Golay, A., Monnin, D., Aminian, K., Staal, J. B., & de Bruin, E. D. (2010). The gait and balance of patients with diabetes can be improved: A randomised controlled trial. Diabetologia, 53(3), 458–466. https://doi.org/10.1007/s00125-009-1592-4

Bodman, M. A., Dreyer, M. A., & Varacallo, M. A. (2025). Diabetic Peripheral Neuropathy. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK442009/

Goldberg, A., Ebraheem, Z., Freiberg, C., Ferarro, R., Chai, S., & Gottfried, O. D. (2018). Sweet and Sensitive: Sensory Processing Sensitivity and Type 1 Diabetes. Journal of Pediatric Nursing, 38, e35–e38. https://doi.org/10.1016/j.pedn.2017.10.015

Holtzer, R., George, C. J., Izzetoglu, M., & Wang, C. (2018). The effect of diabetes on prefrontal cortex activation patterns during active walking in older adults. Brain and Cognition, 125, 14–22. https://doi.org/10.1016/j.bandc.2018.03.002

Kenemore, J., Chavez, J., & Benham, G. (2023). The pathway from sensory processing sensitivity to physical health: Stress as a mediator. Stress and Health, 39(5), 1148–1156. https://doi.org/10.1002/smi.3250

Motor dysfunction in diabetes. (n.d.). Retrieved May 14, 2025, from https://www.researchgate.net/publication/221772224_Motor_dysfunction_in_diabetes?utm_source=chatgpt.com

Muramatsu, K. (2020). Diabetes Mellitus-Related Dysfunction of the Motor System. International Journal of Molecular Sciences, 21(20), 7485. https://doi.org/10.3390/ijms21207485

Muscle Strength in Type 2 Diabetes | Diabetes | American Diabetes Association. (n.d.). Retrieved May 14, 2025, from https://diabetesjournals.org/diabetes/article/53/6/1543/11775/Muscle-Strength-in-Type-2-Diabetes

Paul, L., Ellis, B. M., Leese, G. P., McFadyen, A. K., & McMurray, B. (2009). The effect of a cognitive or motor task on gait parameters of diabetic patients, with and without neuropathy. Diabetic Medicine, 26(3), 234–239. https://doi.org/10.1111/j.1464-5491.2008.02655.x

Petrofsky, J., Lee, S., & Bweir, S. (2005). Gait characteristics in people with type 2 diabetes mellitus. European Journal of Applied Physiology, 93(5), 640–647. https://doi.org/10.1007/s00421-004-1246-7