Diabetes is an established risk factor for falls. Diabetic peripheral neuropathy (nerve damage affecting sensation, movement and balance) is a common complication of diabetes that disposes elders to a higher risk of falling.
Peripheral neuropathy (PN) is caused by high blood sugar levels that damage nerves in the arms and legs. Damaged nerves have trouble effectively carrying messages between the brain and other parts of the body. Signs of PN include:
- Touch sensitivity. Individuals experience a heightened sensitivity to touch, or a tingling or numbness in their feet, legs or hands. The symptoms are often worse at night.
- Muscle weakness. Chronically elevated blood sugars can also damage nerves that tell muscles how to move. This can lead to muscle weakness. Individuals may have trouble walking or getting up from a chair.
- Balance problems. Individuals may feel more unsteady than usual and uncoordinated when they walk. This occurs when the body adapts to changes brought on by muscle damage and weakness.
Exercises and Benefits
Exercise is safe (and strongly recommended) for people with diabetic PN. Along with diet and medication, exercise helps keep blood sugar in control, which prevents a worsening of both diabetes and PN.
The most effective exercises for diabetics to help avoid falls include a combination of leg-strengthening activities and aerobics or walking (either on a treadmill or on the ground), plus tai chi for balance and strength. Exercising improves reaction time, balance and walking ability.
The frequency of exercise should be at least three days/week for aerobic exercise and two days/week for muscle-strengthening activities.
Exercise programs appear to be well-tolerated by diabetics.
Elders with diabetes and PN generally have other chronic health conditions and medications. Therefore, special care must be taken when exercising. Individuals need to ask their health provider which types of exercises are best for them.
Exercises tailored for each person’s preferences and limitations is highly effective not only for sugar control, but also to avoid health complications, such as low blood pressure, dehydration and/or dangerous drops in blood pressure.
Joining an exercise class can be of benefit for several reasons. First, there is an exercise leader to make sure that exercises are being performed safely; second, there is someone to call for emergency help, if necessary; and third, a structured experience helps the person learn how their body reacts to exercising and gives them more confidence to exercise on their own.
Rein Tideiksaar Ph.D., PA-C (or Dr. Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (healthcare professional who specializes in working with elderly patients) and a geriatric physician's assistant. Check out Dr. Rein’s professional profile on LinkedIn: http://www.linkedin.com/pub/dr-rein/6/759/592. If you have any questions about preventing falls, please feel free to email Dr. Rein at firstname.lastname@example.org.