Finding the Right Balance When Living With Type 1 Diabetes

Life is a balancing act, right? When living with type 1 diabetes, we think of a balanced diet, balancing work with play, balancing your insulin requirements, and balancing your medical appointments with other, more enjoyable social activities. But how often do we think of balance as an important part of fitness?

An Increased Risk of Falling

And we don’t mean falling in love. When living with type 1 diabetes, studies have shown you may be at an increased risk of falls, particularly the more birthdays you celebrate, when compared to adults not living with diabetes. Sadly, falls are considered to be a leading cause of injury, hospitalisation, and even fatalities, among older adults.¹

Living with diabetes, whether type 1 or type 2, puts you at a higher risk of associated limited joint mobility, which commonly occurs in the hands but can also be found in other joints such as the feet and ankles. The stiffness and reduced range of motion in these joints as a result of elevated blood glucose levels may contribute to trips and falls.²

Another contributing factor for falls when living with type 1 diabetes is peripheral neuropathy. Peripheral neuropathy is a group of conditions relating to damage of the nervous system that carries messages between the brain and spinal cord [the central nervous system] and the rest of the body. Damage to sensory nerves can cause difficulties with sensing your body’s position in space and maintaining your balance.³

But let’s balance the bad news with some good news – balance exercises can help!

Although further studies are needed to investigate the use of balance training specifically in type 1 diabetes, studies looking at balance exercises in older adults living with type 2 diabetes found that this type of exercise training was able to significantly decrease the risk of falls. Researchers found that even though leg strength was not necessarily improved, the study participants displayed improved reaction times, awareness of the position and movement of their legs [known as lower limb proprioception], and overall balance ability.⁴

5 Balance Exercises To Try At Home

Whether you’re living with type 1 diabetes and are just wanting to add some balance to your life or you’re hoping to step out on a tightrope walking adventure, here are some exercises you can incorporate into your routine to help you stay on your feet [whether one foot or two!].

1. The tree pose. Stand straight with your arms outstretched overhead. Slowly lift one foot and rest it against the calf of your standing leg. See how long you can hold your balance before doing the same on the other leg.

2. Leg lunges. Although lunges are typically thought of as a strengthening exercise, they will naturally require some balance as you bring one leg forward or back, depending on which direction you prefer to do your lunges. As a bonus, you get to tone those quads and glutes too!

3. Walk heel to toe. This isn’t just an exercise for proving to the police you aren’t drink driving. Try to walk in a straight line by putting one foot directly in front of the other, so that your heel of your forward foot is touching the toe of your foot behind.

4. Calf raises. Standing upright, slowly raise yourself up and down on your toes. You’ll feel your calves getting a good workout from this, as well as your ankles working to keep you stable and balanced. If you’re feeling pretty good you can try this exercise on one foot at a time. Our video, Be Active. Stay Active [hyperlink], gives you an easy-to-follow demonstration of this exercise.

5. Standing under-the-leg clap. While standing, raise one leg up with a 90-degree bend at your knee. Bring your hands overhead for a clap then lower your arms so your hands can meet under your raised knee for another clap. If you can accomplish this a few times you’ll pretty much be giving yourself a well-deserved round of applause!

Tips to Avoid Tipping Over

Experiencing a fall while doing an exercise that’s meant to be decreasing your risk of falls would not be great. Before you get started, consider these 3 key tips:

• If you’re feeling wobbly, try your exercises within grabbing distance of a wall, table, or sturdy chair.
• Monitor your blood glucose levels and be prepared for a hypoglycaemic event by following your usual hypo treatment [that has been recommended by your diabetes healthcare team]. If you’re wearing an insulin pump [hyperlink] you may also want to consider adjusting the basal rate to match your exercise to avoid dropping below your normal blood glucose range.
• Work with your diabetes healthcare team to find out which balance exercises are right for you.

Final Thoughts

Although starting out with balance exercises may feel a little wobbly at first, they can be a valuable tool for improving stability and decreasing your risk of falls. Just take it one step at a time, heel to toe!

References

1. Gerards, M.H., McCrum, C., Mansfield, A. and Meijer, K. Perturbation-based balance training for falls reduction among older adults: Current evidence and implications for clinical practice. Geriatr Gerontol Int.2017;17: 2294-2303
2. El- Kader SMA. Impact of ankle joint mobility on balance performance in elderly type 2 diabetic subjects. MOJ Gerontol Ger. 2018;3[1]:42-46
3. National Institute of Neurological Disorders and Stroke. Peripheral Neuropathy Fact
   Sheet. https://www.ninds.nih.gov. 2020. Available at:
   https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet. [Accessed September 2021].
4. Morrison S, Simmons R, Colberg S, Parson H, Vinik A, Supervised Balance Training and Wii Fit–Based Exercises Lower Falls Risk in Older Adults With Type 2 Diabetes. J Am Med Dir Assoc. 2018;19[2]:185.e7-185.e13