Balance and Avoiding Falls

Improving balance and preventing falls when you have diabetes.

As someone with diabetes, you know that maintaining balance is one of the most important things you can do to protect your health. But did you know that diabetes can also affect your balance and that this can increase your risk of falls? In fact, according to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related death among adults over 65 years old in the United States. Many of these deaths could be prevented if people took a few simple precautions to reduce their risk of falling.

Fortunately, there are things you can do to improve your balance and help prevent falls. In this article, we’ll discuss what balance is and why it’s important, how diabetes affects balance, and some exercises you can do to improve your stability. We’ll also look at ways to reduce your risk of falling and suggest ways to make your home or workplace safer if you’re concerned about falling. Finally, we’ll provide tips on when to see a doctor if you’re worried about neuropathy or other complications related to diabetes.

Always discuss exercise with your doctor BEFORE starting any kind of exercise program. This is especially important if you are on medications. Full disclaimer here.

What Is Balance and Why Is It Important?

Balance is the ability to maintain your body’s center of gravity over your feet. It is important because it helps you to stay upright and avoid falling.

Maintaining balance is important for everyone, but it can be especially challenging for people with diabetes. This is because diabetes can cause neuropathy or nerve damage. This nerve damage can cause problems with balance and coordination.

How Does Diabetes Affect Balance?

There are two types of diabetes-related balance problems: static balance and dynamic balance. Static balance refers to your ability to maintain equilibrium while standing still. Dynamic balance refers to your ability to maintain equilibrium while moving.

Both types of balance can be affected by diabetes. When you have diabetes, your body doesn’t use glucose (sugar) as well as it should. This can cause a build-up of sugar in your blood. Over time, this can damage the nerves in your feet and legs. This nerve damage can make it difficult to maintain your balance.

Peripheral Neuropathy

Close up view of a woman's foot with peripheral neuropathy.Diabetes can cause problems with balance by damaging the nerves that help you sense where your body is in space (called proprioception). This damage, called peripheral neuropathy, can occur in both type 1 diabetes and type 2 diabetes. It most often affects the feet and legs but can also affect the hands and arms.

Peripheral neuropathy can make it difficult to know where your limbs are in space and to feel if you are touching something or if something is touching you. This can make it hard to walk and to know if you are about to step on something or trip over something. Peripheral neuropathy is associated with impaired balance and with an increased risk of falls.

Diabetes can also cause problems with balance by damaging the blood vessels that supply blood to your nerves. This can lead to a condition called diabetic neuropathy. Diabetic neuropathy most often affects the feet and legs but can also affect the hands and arms.

Complications of diabetic neuropathy include falls, foot ulcers, pain, nerve damage, and reduced blood flow to the feet. 

One study found that patients with diabetes had decreased dynamic balance and stability compared to a control group of patients without diabetes. Further research has found that patients with diabetic neuropathy significantly benefit from balance training, resulting in improved stability.

Risk Factors for Falling

There are many risk factors for falling, including:

  • Poor vision
  • Use of certain medications (such as sedatives or antidepressants)
  • Alcohol use
  • Poor footwear
  • Muscle weakness
  • Poor balance

How Can I Prevent Falls?

Supportive shoes and socks for balance and avoiding falls.There are several things you can do to prevent falls, including:

  • Wear shoes with good support.
  • Avoid socks on slippery surfaces such as wood floors.
  • Take care of your feet and keep them clean and dry.
  • Check your blood sugar levels regularly.
  • Exercise to improve your strength and balance.

Exercises to Improve Balance and Stability

If you have diabetes, it is important to include exercises to improve balance in your fitness routine. Research has found that specific training can improve gait speed, balance, muscle strength, and joint mobility in patients with diabetes.

Remember to rest between sets to ensure you don’t get tired and keep good form. Here are some exercises that can help improve your balance stability.

Please consult your doctor or health care professional before starting any new exercises to determine if they suit your needs. This website offers health, nutritional, and fitness information and is designed for educational purposes only. Do not start any fitness program or exercise if your doctor advises against it. You should stop exercising immediately if you experience faintness, dizziness, pain, or shortness of breath. Full disclaimer here.

Exercises For People With Neuropathy

If you have Neuropathy, it is important to do exercises that allow you to brace yourself by either holding onto a chair, a doorway, or being seated. If your balance is really poor, choose exercises you can perform while seated to prevent injury from losing balance.

  1. Seated leg raises: Sit in a chair with your feet flat on the floor. Slowly raise one leg straight out in front of you and hold for 5 seconds. Return to the starting position and repeat with the other leg. Do two sets of 10 repetitions.
  2. Standing on one leg: Stand behind a chair or countertop for support. Slowly lift one leg off the ground and hold for 10 seconds. Return to the starting position and repeat with the other leg. Do two sets of 10 repetitions.
  3. Standing marches: Use a doorway or chair to help retain your balance throughout the exercise. Slowly raise one knee so that your knee is the same height as your hip joint (your thigh will be parallel to the floor). Next, slowly lower your leg until both feet are on the ground. Repeat on the other leg. Do two sets of 10 repetitions where 1 repetition is raising both the right and left knee into the air.

Exercises For People Without Neuropathy

In addition to the three exercises listed above, if you don’t have neuropathy consider these slightly more advanced exercises to improve balance. Be sure to use proper form. If you are unsure of the proper form, we recommend watching a video with someone demonstrating and explaining the proper form of the exercise.

  1. Sit-to-stand: Sit toward the front edge of a sturdy chair. Your knees should be bent, and your feet should be flat on the floor, shoulder-width apart, and beneath your hips. Place your hands on each side of the chair, keeping your back straight and chest slightly forward. Take a breath in and as you start to exhale, slightly lean forward to stand up. Once standing, start to breathe in as you slowly sit back down on the chair. Make sure the chair is sturdy and won’t move out from under you. As you slowly sit back down, engage your core to help lower your body. Do this 10-15 times for two sets.
  2. Squats: If sit-to-stand becomes too easy and you feel you have good balance, a squat should be a little more challenging. Only do this if sit-to-stand becomes too easy, and you have good balance. Stand with your feet shoulder-width apart. Point your toes out just slightly. Look straight ahead and pick a spot on the wall in front of you (this will help maintain proper form). Put your arms straight out in front of you, parallel to the ground. Try to keep most of the weight on your heels and your core engaged. Breathe in on your way down and breathe out on your way up. Sink your hips down and back to where you are sitting in an imaginary chair. If your hips can go lower than your knees, squat until your thighs are parallel to the floor. As you raise back up, exhale and keep your core tight. Squeeze your butt/glutes at the top to engage your glutes. If you need to become more familiar with how to squat correctly, we recommend you look up a video on proper form. The squat is a very important exercise to include in any program; however, it is also an exercise that can cause severe injury if not performed correctly. Perform 10 repetitions for 2-3 sets.
  3. Heel-to-toe walking: Place your heel just in front of your toes and walk forward. As you walk, touch your heel to your toe and then step forward with your opposite foot so that your heel is in front of your toes again. Repeat this pattern, walking as far as you can.
  4. Standing marches: This is the same exercise as above, however, with the use of an unstable surface to engage more of your core. Stand on a pillow or foam pad. Slowly raise one leg so that your knee is the same height as your hip joint (your thigh will parallel the floor). Slowly lower your knee until both feet are on the ground. Slowly raise the other leg to where your knee is the same height as the hip joint, then slowly lower it. Do two sets of 10 repetitions where 1 repetition is raising both the right and left knee into the air.
  5. Standing on an unstable surface: Stand on a pillow, foam pad, or stability ball. Make sure you are steady before trying any exercises. Once you are steady, try lifting one leg off the ground and holding it for 10 seconds. Return to the starting position and repeat with the other leg. Do two sets of 10 repetitions.

Tips to Reduce Falling

There are several things you can do around your home or workplace to reduce your risk of falling, including:

  • Woman using a handrail in the bathroom for balance and avoiding falling.Remove any tripping hazards, such as rugs or cords, from walkways.
  • Arrange furniture so that there are clear paths to walk through.
  • Install grab bars in the bathroom and near the bed.
  • Use nonslip mats in the bathtub and shower.
  • Wear shoes with good support.
  • Don’t wear socks on slippery surfaces such as tile or wood floors.
  • Add lighting in dark areas.
  • Make sure all stairways have handrails.
  • Keep your home or work area well organized.
  • Avoid walking in slippery or wet conditions.
  • Take breaks often if you feel tired.
  • Ask for help when you need it.

When Should I See My Doctor?

You should see your doctor if you have diabetes and you:

  • Have any changes in your vision.
  • Have numbness or tingling in your feet.
  • Fall more often than usual.

Please note that this content is meant to be used as general information and is not intended to replace professional medical advice. If you have diabetes and are experiencing changes in your vision, numbness or tingling in your feet, or falling more often than usual, please see your doctor.