Watch Out! Home Hazards for People With Diabetes
No one wants to think about getting seriously hurt just going about their day in their own home, but as we age, we have an increased risk of falling. That risk is especially high if you have type 2 diabetes.
That's in part because eye diseases like diabetic retinopathy (DR) or diabetic macular edema (DME) can interfere with vision, according to research published in JAMA Ophthalmology. Similarly, diabetic neuropathy (DN), a type of nerve damage, can greatly impact balance. What can you do to stay safe? Start by addressing these potentially hazardous areas of your home.
Rugs can be a trip hazard, especially if placed over hardwood or tile. "Carpets that can move and slip are a big fall risk, especially if they're in a home where a person needs a walker, cane, or crutch to move around," says Dustin French, Ph.D., associate professor of ophthalmology at Northwestern University Feinberg School of Medicine in Chicago. Minimize your risk of tripping: Remove rugs in your home that can't be stapled down.
Uneven Floor Surfaces
Even if you don't have carpet, it's unlikely all the floor surfaces are even. Dr. French says to be mindful of different floor types, such as rooms that go from linoleum to wood to carpet, because there may be gaps or small lifts from one room into another. Make sure you wear sturdy, comfortable shoes and when you walk, try to pick up your feet instead of shuffling to prevent tripping.
Lack of Lighting
Rooms that are dark or have lamps placed in a hard to reach areas may make it more difficult to see, causing a collision with furniture for those who have vision or balance difficulties. To prevent this, Dr. French suggests setting up motion- detector lights in heavily used rooms or making sure any light sources are easy to access near entryways.
Getting in and out of the bathtub can be a hurdle even without diabetes depending on how high your tub ledge. Add in DR or DN and a relaxing activity can become quickly dangerous. "Take extra care around the bathtub and shower, and make sure to use a non-slip mat and/or handrails when getting out or into the tub," says Orlin Sergev, M.D., Ph.D., owner of Equilibrium Endocrinology & Diabetes Center in Ladson, SC. If you can, consider installing a walk-in shower.
Diabetic retinopathy interferes with the eye's ability to absorb light. This can make your vision blurry, and if you're outside, it can increase your chances of falling over a root or a missing sudden shift in terrain like the edge of a patio. Dr. Sergev recommends always making sure you wear sunglasses in bright sunlight to help with vision clarity and sensitivity.
Take the time to make sure hallways are as clear of any obstacles, from furniture to wires, which will help reduce nighttime falls when heading to the bathroom. "For those who have to get up in the middle of the night several times to use the bathroom (such as a male with an enlarged prostate), any tables or objects in the hallway could present a problem," says Dr. French.
No matter where you are in your home, if you don't have on the proper shoes, your risk of falling is higher. Even if you tend to wear sneakers, Dr. French says to remember that the soles can grab carpeting easily and cause traction, so again, be mindful about picking up your feet as you walk. In one small study in the Journal of the American Podiatric Medical Association, choice of footwear influenced the sense of balance and confidence in people with diabetes. Ditch shoes that feel too heavy to move in and those with slippery soles.
Your Medicine Cabinet
It's important to review all medications you're taking with your doctor, says Dr. Sergev, as the interaction of certain drugs may make you feel dizzy or lightheaded. When combined with blurry or reduced vision, a poor prescription interaction can make it all too easy to have a fall. Dr. French says your primary-care doctor should be communicating with your endocrinologist as well as any other specialists you're seeing. To be safe, write down your meds or stick them in a plastic baggie before your next appointment to have your doctor double-check any potential side effects.
Staying in good physical condition is a great way to help prevent falls, says Dr. Sergev. Dr. French agrees, adding that inactivity can lead to muscle loss, weakness, and even arthritis. "Vision has been shown to be an independent risk factor for falling, but there are modifications that can be done around the home to reduce that risk," says Dr. French. Grab bars, handrails, add walking-assistance aids like canes and walkers can help you stay active and on your feet.
Impact of neuropathy on falls: Plos One. (2016). "The Impact of Diabetic Neuropathy on Balance and on the Risk of Falls in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study." https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154654
Impact of diabetic retinopathy on falls: JAMA Ophthalmology. (2017). "Association Between the Severity of Diabetic Retinopathy and Falls in an Asian Population With Diabetes: The Singapore Epidemiology of Eye Diseases Study." https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2663389
Diabetes and falling risk: UC Berkeley School of Public Health. (2017). "Why Diabetes Raises Your Risk of Falling." https://www.healthandwellnessalerts.berkeley.edu/topics/diabetes/why-diabetes-raises-your-risk-of-falling/