Diabetes and Increased Fall Risk

Diabetes increases risk of falling because it causes physical problems that may make your loved one less steady on their feet.

Helpful Highlights

  • 'Person(s) with diabetes' is often abbreviated PWD.

  • Older adults with diabetes are at significantly higher risk for falls.

  • They are also prone to more severe problems from falls.

  • Daily activity at their highest level is essential in avoiding falls.

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A concerning link exists between diabetes and falls in the elderly. Research shows that older adults with diabetes have a greater risk of falls, especially those treated with insulin. One study found that persons with diabetes (PWD) aged 65 or older are 17 times more likely to fall than a younger person without diabetes.

Individuals, especially the aging population, fall because of:

  • decreased function in basic movements like walking and grasping

  • decreased function in senses like vision and hearing

  • problems with muscle control and strength

  • foot and body numbness or pain

  • medication complications resulting in high and low blood sugar (causing dizziness, confusion, fatigue, and weakness)

  • specialty footwear devices

Additionally, there is some concern that persons with diabetes (PWD) are prone to more severe problems with falls than those without diabetes, such as:

  • fractures

  • poorer rehabilitation

  • recurrent falls and increased number of falls

Fortunately, efforts to minimize the number and severity of falls in PWD show promise. Balance, strength, and gait training successfully reduce fall risk in this population. Furthermore, new technologies such as virtual reality proprioceptive training* may be able to reduce risk within a safe training environment.

*Proprioceptive training enhances awareness of position and movement of the body, and consequently enhances motor function and performance. This is especially valuable in PWD because of peripheral neuropathy (reduced or absent sensation in feet and lower legs and/or hands and lower arms). Exercises that improve balance also improve proprioception.

To avoid falls, the American Diabetes Association (ADA) recommends keeping active at whatever level is appropriate for your loved one, focusing especially on those activities that promote balance and strength. Physical therapy can help with this, as well as pool aerobics, gentle yoga or pilates, and classes aimed at balance training for seniors. For example, SilverSneakers offers a 10-minute Better Balance Workout and a full 7-day Better Balance Challenge.

Medicare and Medicare Advantage plans offer membership in SilverSneakers, along with many other benefits aimed at diabetes health maintenance. Encourage your loved one to take advantage of these benefits and other local community offerings.

RESOURCES

American Diabetes Association Schwartz, A.V., et al. (2002). Older women with diabetes have a higher risk of falls: A Prospective Study. Diabetes Care, 25(10), 1749-1754. DOI

Crews, R.T., Yalla, S.V., Fleischer, A.E., & Wu, S.C. (2013). A growing troubling triad: Diabetes, aging, and falls. Journal of Aging Research, 2013. doi: 10.1155/2013/342650

Vinik, A.I., Camacho, P., Reddy, S., Valencia, W.M., Trence, D., Matsumoto, A.M., & Morley, J.E. (2017). Aging, diabetes, and falls. Endocrine Practice, 23(9), 1117-1139. DOI: 10.4158/EP171794.RA

Yang, Y., Hu, X., Zhang, Q., & Zou, R. (2016). Diabetes mellitus and risk of falls in older adults: A systematic review and meta-analysis. Age and Ageing, 45(6), 761-767. DOI

Yee Cheng, L., Yan Leung, S., & Wa Leung, M.K. (2022). The association of glycemic control and fall risk in diabetic elderly: A cross-sectional study in Hong Kong. BMC Primary Care, 23, 192. Link

No content in this app, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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