Can Exercise That Trains Both Body and Brain Reduce Falls in Older Adults With Type 1 Diabetes?

Falling is a serious health risk for older adults with Type 1 diabetes. The condition damages nerves in the feet and legs (neuropathy), weakens bone density, and can affect the heart and blood vessels—all factors that increase fall risk and the injuries that follow. These falls can lead to broken bones, hospitalization, and loss of independence.

Current fall-prevention programs typically focus on building leg strength and improving balance. However, safe movement in real-world environments—navigating stairs, walking on uneven surfaces, or stepping around obstacles—requires more than muscle power. It also demands the brain and body to work together seamlessly, a skill called cognitive-motor integration. Most programs do not train this coordination.

The DiaActive trial is a randomized controlled study enrolling 220 older adults with Type 1 diabetes (along with 220 people with Type 2 diabetes). Participants will be randomly assigned to either a 26-week cognitive-motor exercise program or usual care.

The exercise program, called RYMA, involves two supervised sessions per week combining rhythm-based motor training with strength and balance exercises designed around everyday activities like climbing stairs or picking things up safely.

The main goal is to count how many falls occur during the intervention. Beyond falls, the trial will track balance performance, bone density, fractures, progression of nerve damage, heart disease risk markers, muscle strength, and cognitive function. Researchers will continue following participants for up to 5 years to see if benefits last.

This comprehensive approach recognizes that fall risk involves multiple systems in the body—not just muscles and balance, but also nerves, bones, circulation, and thinking skills.

The DiaActive trial is still underway, so results are not yet available. However, the study design reflects a growing understanding that keeping older adults with diabetes safe and active requires training the whole person—body and mind together. When results are published, they may offer new insights into whether this combined approach works better than traditional fall-prevention methods for people with Type 1 diabetes.

Source: Diabetic medicine : a journal of the British Diabetic Association. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.