Diabetes is a growing problem, affecting more than 29% or 15 million people over the age of 65 in the United States. It affects many systems within the body and can increase your risk of falling in a number of specific ways but recent research showed that most patients are not aware their condition puts them at increased risk for falls and fractures. Here are five key ways that diabetes increases your risk of falling.

Changes in Blood Sugar

Diabetes means that your cells can’t access glucose, either because you’re not producing enough insulin, or because the cells don’t recognize the insulin. The medications you take to manage this can sometimes result in too little glucose in your blood (hypoglycemia), which can make you feel weak, sweaty and faint.

What you can do: take your medications at the correct times, eat regular healthy meals and check your blood glucose levels so that you learn what kind of activity affects you. Recognize that if you exercise more than usual, or eat later than usual, your blood sugar level will likely drop, putting you at risk of hypoglycemia. It can be useful to carry some easily digestible carbohydrate like dried fruit or glucose tablets with you.

Blood Pressure Changes

People with diabetes often have higher blood pressure as higher levels of glucose in the blood can lead to atherosclerosis, when there’s a buildup of fatty material inside your blood vessels, narrowing them. If you have diabetes, your doctor will check your blood pressure regularly to make sure it is in a healthy range and may prescribe medications to lower it if it gets too high. These medications can sometimes cause you to feel faint or dizzy, especially if you stand up suddenly from a chair or when you get out of bed for example.

What you can do: Tell your doctor if you experience dizziness from medication as they may be able to try a different dose or alternative medication. You can also protect yourself by being aware of the effect and allowing yourself more time to get up before moving about. Sometimes changes in diet and exercise patterns, and keeping your weight in a healthy range can also help manage blood pressure. Speak to your doctor about appropriate changes you may be able to make.

Gait Speed, Stride Length

Studies have observed that patients with diabetes typically walk more slowly and have a shorter stride than controls of similar age who do not have diabetes. The same group also reported higher incidence of foot pain or numbness and had lower scores on cognitive tests.  The sensations coming in from the bottom of the feet are a vital part of the balance system, especially when moving around. If you suffer from numbness or foot pain, this is going to have a direct negative effect on your body’s ability to balance.

What you can do: Wearing well-fitting shoes and checking your feet regularly for injury is important. You can also stimulate your system by massaging the foot and performing sensorimotor exercises designed to boost the signals coming in through your feet. Some physical therapists specialize in sensorimotor exercises, and you can also look at the ‘Feet’ section of the ZIBRIO BalanceCoach app for suggestions.

If you feel cautious while walking because of foot problems, it is worth investing in an aid like a cane and asking your doctor to refer you to physical therapy for gait and balance training.

Balance & Vestibular System

Another study showed that diabetes can often cause vestibular problems, where people feel dizzy when they move their heads. Researchers believe that high blood sugar damages the nerve endings in the inner ear. As with foot pain or muscular weakness, confusion in the vestibular system reduces balance ability and increases fall risk.

What you can do: Speak with your doctor if you have symptoms of dizziness to discover whether they are caused by medication or something else. This is also another good reason to manage both blood glucose and blood pressure over the long term, to avoid damage to the vestibular system and to other organs in the body.

Balance training, including strength exercise may be right for you, but it’s important to check with your doctor first so you don’t put yourself in danger.

Bone Strength

Diabetes weakens bones, even when compared to controls without diabetes with similar age and bone density. In fact, people with diabetes who fall are 65% more likely to break a bone than those of the same age who do not have the disease. This makes it important to work on both your intrinsic balance capability – with appropriate strength and balance training, under doctor’s supervision, as well as manage the hazards in your environment. What you can do: Removing loose rugs or cords in the home, removing clutter, and using non-slip mats in baths and showers take on a higher importance for older adults living with diabetes. Consider getting a walking aid – it’s easier to use than crutches! Bear in mind that diabetes often makes it harder for the body to heal after injury. Prevention is always better than cure.

Many people are living with diabetes, and there are more and more options for leading a full life. Keeping active, eating healthily, getting good sleep are good for your diabetes management as well as your balance. Being aware of your risk of falling and the various elements that affect it can help keep you ahead of the game and out of the hospital.

Did you know – many doctors and physical therapists around the country are already using ZIBRIO Stability scales to help their patients take control of their balance health. Tell your care team about us. Don’t want to share? You can get a scale for your own home here.