The Fall Risks of Diabetes

Diabetes, It Affects Your Sugar but Did You Know It Can Increase Your Risk of Falling ?


Each year, 30 percent of persons aged greater than or equal to 65 years suffer a fall and 13,700 of those individuals died from that injury in 2003. Between 1993 and 2003, the rate of fatal falls among this age group had increased. Did you know that the incidence of diabetes is also increasing in this age group and diabetes is now one of the top 5 chronic medical conditions affecting Americans? As diabetes progresses, many individuals suffer from nerve damage as a result of increased levels of sugar in their blood. Nerve damage, also known as neuropathy, can decrease ones ability to feel their feet and legs. The lack of feeling makes it difficult for a person to sense where their feet are with respect to the ground. This loss of feeling is called a loss of proprioception and increases the risk of falling. Some medications prescribed for diabetic nerve pain can also cause drowsiness, dizziness or weakness that further increases the risk of falling. Consider these steps towards reducing you or someone you care about risk of falling when they have diabetes:

· Use night lights along the path to the bathroom and hallways at night. Our sense of balance depends on our nerves to our feet as well as sight. Vision becomes even more important for balance when there is nerve damage to the feet so make sure walking areas are well lit.
· Beware of the side affects of medications such as drowsiness, dizziness or weakness that may increase your risk of falling. Consult your physician about changing medications if this occurs.
· Avoid use of house slippers and flip flops. This type of footwear is loose on the foot and a lack of feeling in the feet makes them more likely to slide or twist off the foot and cause a fall
· Avoid uneven terrain, especially in dimly light areas. Gravel surfaces, hills and inclines are more challenging and require more balance.

Turf Toe

Turf Toe, Tough Turf, or Tough Luck

Now that football season has kicked off again, players on the professional, college and high school level are at risk for a numbers of foot injuries that can not only end their season, but leave them with lasting injuries. Turf Toe is one of those injuries that affects athletes and sports enthusiasts at all competitive levels.

Picture of Carbon FootPlate with Morton Extension Above

Dr. Robert Joseph D.P.M., Ph.D. relates that turf toe is caused by injury to the ligaments of the great toe joint when the joint is overstretched. Although it is most commonly associated with football injuries, it can occur with any sport prone to rapid changes in direction of running such as soccer or tennis. Once thought to be related to the unforgiving properties of artificial turf, greater understanding of foot and shoe gear mechanics show improper shoe selection and foot mechanics may also be risk factors for injury.

According to Dr. Joseph, the great toe is associated with several types of sports related injuries than can be difficult for the layman or physician to distinguish. These injuries include fractures of the two small bones of the great toe joint called the sesamoids, rupture of ligaments, or injury to the cartilage of the joint’s surface. Evaluation by a foot specialist is not only an integral part in determining the type of injury and treatment but also guides rehabilitation and proper shoe selection. Use of a proper shoe gear can reduce the risk of injury and at times, a carbon fiber foot plate with a mortons extension can be used to reduce joint strain as an athlete returns to sports after a turf toe injury. Dr. Joseph relates that proper shoe gear selection is not as easy for patients as it once was given the variety of shoe types, styles and technologies available. Choosing a knowledgeable and reputable shoe store can also make a significant difference helping one get the right type of shoe recommended by your foot and ankle specialist.


Robert Joseph D.P.M., PH.D., is a podiatric clinician and researcher in private practice in Dayton, Ohio. He is adjunct faculty of the University of Dayton, Dayton Ohio and Clinical Research Associate of the Tissue Regeneration and Engineering Center of the University of Dayton and Providence Center For Clinical Research. For more information, visit robertjosephpodiatry.mobi. or call (937) 479-1793