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Hypoglycemia and hyperglycemia are risk factors for falls in the hospital population

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A Letter to the Editor to this article was published on 22 June 2019

Abstract

Objective

To determine the role of hypoglycemia, hyperglycemia or the combination of both as independent risk factors for falls in a hospital population. Secondary objectives included evaluation of other risk factors for falling and their relationships with glucose levels.

Research design and methods

Retrospective cohort study over 2 years on hospitalized subjects (N = 57411) analyzing in-hospital-falls and capillary glucose values. Bivariate analysis (χ2 test) and multivariate analysis (logistic regression) were performed to test for correlation of glucose values, age, sex, Charlson index, service of care, diagnosis at discharge and diabetes treatment with risk of in-hospital-falls.

Results

The comparison of patients who experienced a fall (fall population) with the non-fall population suggested that: glucose determinations were significantly more frequent in the fall population (OR 3.45; CI 2.98–3.99; p < 0.0001); values of glucose below 70 mg/dl and over 200 mg/dl were significantly associated to falls during hospitalization (OR 1.76; CI 1.42–2.19; p < 0.001) as compared to glycemic values between 70 and 200 mg/dl; diabetes treatment was significantly correlated to risk of fall (OR 2.97; CI 2.54–3.49; p < 0.001); the frequency of glycemia measurements below 70 mg/dl and over 200 mg/dl in the same subject was significantly associated to falls during hospitalization (OR 1.01; CI 1.01–1.02; p < 0.001).

Conclusion

Hypoglycemia and hyperglycemia during hospital stays are correlated with an increased risk for falls in the hospitalized population. Presence of diabetes, use of insulin or glucose variability could potentially constitute risk factors for falls inside the hospital as well.

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Acknowledgements

Parts of this work have been presented in abstract form at the meetings of IDF 2017 and EASD in 2018.

Author information

Authors and Affiliations

  1. Metabolic Disease and Diabetes, Multimedica IRCCS, Milan, Sesto San Giovanni, Italy

    Cesare Berra

  2. Quality Monitoring Office, Humanitas Clinical and Research Hospital, Milan, Rozzano, Italy

    Francesco De Fazio & Marco Albini

  3. Clinical Quality Department, Humanitas Clinical and Research Hospital, Milan, Rozzano, Italy

    Elena Azzolini & Federico Zangrandi

  4. Metabolic Disease and Diabetes, Humanitas Clinical and Research Hospital, Milan, Rozzano, Italy

    Marco Mirani

  5. Departmental Unit Diabetes and Metabolic Disorders, ASST Santi Paolo e Carlo, Milan, Italy

    Stefania Garbossa & Franco Folli

  6. Department of Health Science, University of Milan, Milan, Italy

    Stefania Garbossa & Franco Folli

  7. Research Department, Hospital Regional de Alta Especialidad del Bajío, León, Mexico

    Rodolfo Guardado-Mendoza

  8. Department of Medicine and Nutrition, University of Guanajuato, León, Guanajuato, Mexico

    Rodolfo Guardado-Mendoza

  9. Department of Cardiovascular Medicine, Humanitas Clinical and Research Center - IRCCS, Milan, Rozzano, Italy

    Gianluigi Condorelli

  10. Humanitas University, Milan, Italy

    Gianluigi Condorelli

  11. Institute of Genetics and Biomedical Research (Milan Unit), National Research Council of Italy, Milan, Rozzano, Italy

    Gianluigi Condorelli

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  1. Cesare Berra
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  2. Francesco De Fazio
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  10. Franco Folli
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Corresponding authors

Correspondence to Cesare Berra or Franco Folli.

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The study was approved by the Ethical Committee of the Humanitas Research Hospital, Rozzano, Milano, Italy.

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All clinical and laboratory informations came from retrospective analysis from non identifiable data, informed consent was not deemed necessary by the Ethical Committee.

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Berra, C., De Fazio, F., Azzolini, E. et al. Hypoglycemia and hyperglycemia are risk factors for falls in the hospital population. Acta Diabetol 56, 931–938 (2019). https://doi.org/10.1007/s00592-019-01323-8

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  • DOI: https://doi.org/10.1007/s00592-019-01323-8

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