Brief Answer: Cardiac and Neurological evaluation are required Detailed Answer: Hi XXXX Thanks for your query. The imbalance problems can be due to atrial flutter, which is itself an unstable rhythm and can revert to intermittent atrial fibrillation(AF). AF can directly cause balance problems or, indirectly following a minor thromboembolic stroke. From the Medical History, I gather that the patient is also a Diabetic. Autonomic Neuropathy- as a diabetic complication- may be causing orthostatic hypotension, which the patient perceives as balance problem. It would therefore be advisable to refer the patient immediately to * a cardiologist for further evaluation- including Holter monitoring; and, * a Neurologist to evaluate for development of autonomic neuropathy or a minor thromboembolic stroke. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Take care Dr. Rakesh Karanwal

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