There is a significant and troubling link between diabetes (DM) and falls in the elderly. Individuals with DM are prone to fall for reasons such as decreased sensorimotor function, musculoskeletal/neuromuscular deficits, foot and body pain, pharmacological complications, and specialty (offloading) footwear devices. Additionally, there is some concern that DM patients are prone to have more severe problems with falls than non-DM individuals. Fractures, poorer rehabilitation, and increased number of falls are all concerns. Fortunately, efforts to mitigate falls by DM patients show promise. A number of studies have shown that balance, strength, and gait training may be utilized to successfully reduce fall risk in this population. Furthermore, new technologies such as virtual reality proprioceptive training may be able to provide this reduced risk within a safe training environment. 1. Introduction From 2000 to 2010 the elderly (65+ years) population in the USA has continued its upward trend, increasing by 5.25 million (15%) to a total of 40.26 million [1]. This amounts to 13% of the entire population [1]. Thanks to the aging baby boomers population, by the year 2050 the elderly population is expected to reach 88.5 million, which would represent 20% of the total population [2]. One of the greatest health challenges facing this population is falls. In 2000 there were a reported 10,300 fatal falls by the elderly in the USA that incurred $179 million in direct medical costs [3]. There were an additional 2.6 million medically treated falls that cost $19 billion in medical costs. Other western nations report similar significant burdens with the United Kingdom reporting ￡981 million (US $1.9 billion) in costs for falls in those 60 or more years old in 1999 [4], and in 2001 the annual cost of care attributable to falls in those 65 or older in Australia was $86.4 million (US $66.1 million) [5]. While the cause of falls is often multifactorial, diabetes mellitus (DM) has been shown to be a significant factor. The significance of the relationship between aging, DM, and falls has been highlighted by previous work that found the annual incidence of falls in elderly individuals with DM to be 39% [6]. This paper will review the association of fall occurrence and diabetes, the association of fall severity and diabetes, and efforts to limit diabetes associated risks for falls. 2. Association between Diabetes and Falls Falls are a major concern for elderly adults with DM [7]. The high prevalence of falls in ambulatory elderly individuals with DM is well established with
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