What do Diabetes and Falling Have in Common

Diabetes is a disease marked by excessive blood sugar. Diabetes is a serious illness that increases the risk of heart attacks and strokes. According to the American Diabetes Association (ADA), more than a quarter of adults over 65 have diabetes. 

Why Diabetes Increases Fall Risk? Diabetes is associated with several complications that increase the likelihood of falling.

Short-Term Complications

Low Blood Sugar
A drop in blood sugar (hypoglycemia) most commonly occurs in diabetics taking insulin, but it can also occur with oral medications that enhance the action of insulin. There are many reasons for a drop in blood sugar, including skipping a meal, exercising more strenuously than normal or not adjusting medication when blood sugar levels change.

Early signs and symptoms of low blood sugar include sweating, shakiness, weakness, hunger, dizziness and nausea. With profound drops in blood sugar, persons may experience slurred speech, drowsiness and confusion.

High Blood Sugar
High blood sugar (diabetic hyperosmolar syndrome) occurs in persons with uncontrolled diabetes or those who don't know they have diabetes. It can also occur if persons are under stress, or have an illness or infection. Signs and symptoms include excessive thirst and increased urination, weakness, leg cramps, and confusion.
Long-Term Complications

Eye Damage
Diabetes leads to visual disorders (diabetic retinopathy, cataracts and glaucoma). The resulting eye changes can contribute to falling (makes it difficult to see things clearly, interferes with depth perception and the ability to quickly adjust from bright to dim light and vice versa).

Nerve Damage
Half of all individuals with diabetes eventually have some type of nerve damage (diabetic peripheral neuropathy) that is characterized by a loss of sensation in the feet and legs, typically in a stocking-and-glove pattern. Nerve damage leads to unsteady balance (when standing and walking) and can also affect one’s mood and sleep patterns, which contributes to fall risk.

Kidney Damage
Diabetes affects the kidneys (nephropathy), which can result in urinary incontinence and/or increased nighttime urination (nocturia or frequent toileting) and fall risk.

Foot Damage
Persons with diabetes can develop foot problems (blisters, corns, calluses, ingrown toenails, etc.), which interferes with walking and balance. Foot problems most often happen when there is nerve damage, which results in loss of feeling in the feet. Diabetic nerve damage decreases the ability to feel pain, heat, and cold or any foot injury. Nerve damage can also lead to changes in the shape of the person’s feet and toes (hammertoes) that contributes to unsafe walking.

Bone Damage
Diabetes leads to loss of bone strength (osteoporosis) that increases the risk of injury, especially hip fractures.

Alzheimer's Risk
Diabetes dramatically increases a person’s risk of developing Alzheimer’s disease (a strong risk factor for falling). Diabetes contributes to dementia in several ways:

• Insulin resistance, which causes high blood sugar and in some cases leads to diabetes 
• Diabetes may interfere with the body’s ability to break down a protein (amyloid) that is linked to Alzheimer’s.

How to Control Diabetes and Fall Risk
The best way to reduce the risk of falls is to avoid any diabetic complications associated with falling. While there is no cure for diabetes, there are steps that elders and caregivers can take to manage diabetes and avoid falls.
To read more of Dr. Reins list of Short Term Complications and Long Term Complications and what can be done to decrease the risks of falling CLICK HERE