You may not think of falling as a diabetes problem, but it’s a big one. Falls are the most common reason for ER visits in people over 45, and diabetes increases the risk. What causes falls, and how can you prevent them?
Diabetes can promote falling in several ways:
Low vision: If your eyes are clouded by retinopathy or you can’t see to the sides because of glaucoma, you may miss things that can trip you.
Balance problems: Neuropathy in your feet and legs can make balance shakier. An uneven surface that wouldn’t have bothered you ten years ago might knock you over now.
Low blood sugars (hypoglycemia): If your glucose level goes low due to medications or not eating, you may get dizzy and fall.
Weakness and tiredness: You might not be at risk for falls when you’re at your best, but you’re not always at your best with diabetes. You may be sluggish; you may have gotten out of shape.
Falls can damage your life as much as any other complication. They are the most common cause of accidental death in Americans over 75 and the main cause of hip fractures, which are extremely disabling.
Fortunately, falls are highly preventable. They’re not really accidents. Falls happen when a dangerous situation is allowed into your life and not removed.
If you lived with a wild tiger in your living room, you couldn’t say it was an accident when the tiger finally ate you. It’s the same with dangerous life situations. Eventually they get you.
You prevent falls by strengthening yourself and creating a safer environment.
Making yourself fall-resistant
1. Exercise. Strengthening your legs and arms with resistance training allows you to stop some falls from happening. Stretching and aerobic exercise will help you get around more easily.
3. Keep your bones strong. See a doctor about medicines, food, and supplements that can keep you from being fragile. Calcium, vitamin D, and magnesium are known to strengthen bones.
4. See a doctor about neuropathy in your feet that can affect balance. Better glucose control can often resolve neuropathy.
5. Maintain good foot care. WebMD says calluses, bunions, or sores on the feet can interfere with balance. Get them taken care of. Get good-fitting, supportive shoes.
6. See an ophthalmologist annually. Treat retinopathy, and get better glasses if necessary.
7. Keep track of your diabetes medicines. If you are on insulin, sulfonylurea drugs (tolbutamide [brand name Orinase], tolazamide [Tolinase], chlorpropamide [Diabinese], glimepiride [Amaryl], glipizide [Glucotrol and Glucotrol XL], and glyburide [Diabeta, Micronase, and Glynase]), or meglatinide drugs (repaglinide [Prandin] and nateglinide [Starlix]), your medicines could take your sugars too low, setting up falls. If you have any sign that your sugars could be going low (like, say, a glucose level below 75–80,) ask your doctor if it’s safe.
Because of lows, older people going for tight glucose control (A1C less than 7.0%) have four times more falls than those with an A1C greater than 7.0%. But poor control can make you sluggish and shaky, too. Work with your educator or doctor to come up with a plan that’s best for you.
8. Be aware that other substances — sleeping pills, pain medicines, alcohol, and cannabis, for example — can also contribute to falls. Be very careful with them.
9. Consider using a walker or quad cane for getting around.
Making your environment fall-resistant
1. Clean up clutter, especially if there are kids around. Make sure floors are kept free of junk you can trip over.
2. Remove tripping hazards, such as thresholds in doorways, carpets, throw rugs, and electrical wires.
3. Reduce the stairs in your life. The fewer stairs you have or times you have to go up and down them, the less chance of falling.
4. Bathrooms are the most common places to fall. Install grab bars and handrails, and get a walk-in shower or a shower bench you can sit on while bathing or use for transferring.
5. Put non-slip strips on tubs and floors to help you stand. Use nonskid floor wax.
6. Clothing should not be around your feet where it can trip you. Keep it shorter or tighter.
7. Better lighting is key. Along with bright room lights, you might want to have a flashlight with you.
8. Wear shoes all the time, as long as they fit well. Shoes prevent slipping and injury from stepping on things.
9. Pets can cause falls. Train them well to stay off the floors where you walk. Keep an eye out for them.
Naturally, people resist making such changes. It’s admitting that we’re getting older or more disabled. I had to go through this a long time ago because of multiple sclerosis. The important thing is to be careful, all the time, and who wants that?
It’s hard to accept, but if you wait until falls actually happen, it may be too late. My friend Juan was 80 years old and had Type 2 diabetes. He insisted on climbing ladders to work on his house and his trees. One day he fell and hit his head. He spent the last three months of his life in intensive care. I’m still sad about that. Keep strong, but be safe.
Want to learn more strategies for avoiding falls? Read “Preventing Falls.”