The incidence of falls in people more than 65 years old results higher if they are affected by Diabetes mellitus in comparison to healthy subjects. Diabetic neuropathy and concomitant retinopathy may strongly contribute to gait instability, but other pathways could also favor the balance impairment associated with diabetic mellitus. The peripheral vestibular system is complex and plays a major role in maintaining balance in both static and dynamic conditions. Therefore, the potential mechanisms by which vestibular end organs may be affected by diabetes mellitus should be considered.
In a study of 1042 individuals aged 65 years and over who were successfully interviewed in a community survey of health and physical activity, 35% reported one or more falls in the preceding year. Although the overall ratio of female fallers to male fallers was 2.7: 1, this ratio approached unity with advancing age. Mobility was significantly impaired in those reporting falls. Asked to provide a reason for their falls, 53% reported tripping, 8% dizziness and 6% reported blackouts. A further 19% were unable to give a reason.
Stepping and Functional Reaction to loss of balance can also be affected in patients with diabetes mellitus. It is likely that the impairment in ability to perform compensatory stepping reactions is an important contributor to the unsteadiness, loss of balance confidence, and risk of falling that is associated with aging and age-related pathology. Same factor can also affect the lateral stability or the need to take several steps to regain balance in elderly. The problems in controlling lateral stability may be particularly relevant given the prevalence of lateral falls in older adults and the links to risk of hip fracture.
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