Journal of General Internal Medicine

, Volume 25, Issue 2, pp 141–146 | Cite as

The Association Between the Number of Prescription Medications and Incident Falls in a Multi-ethnic Population of Adult Type-2 Diabetes Patients: The Diabetes and Aging Study

  • Elbert S. Huang
  • Andrew J. Karter
  • Kirstie K. Danielson
  • E. Margaret Warton
  • Ameena T. Ahmed
Original Article



Use of four or more prescription medications is considered a risk factor for falls in older people. It is unclear whether this polypharmacy-fall relationship differs for adults with diabetes.


We evaluated the association between number of prescription medications and incident falls in a multi-ethnic population of type-2 diabetes patients in order to establish an evidence-based medication threshold for fall risk in diabetes.


Baseline survey (1994-1997) with 5 years of longitudinal follow-up.


Eligible subjects (N = 46,946) had type-2 diabetes, were ≥18 years old, and enrolled in the Kaiser Permanente Northern California Diabetes Registry.

Measurements and main results

We identified clinically recognized incident falls based on diagnostic codes (ICD-9 codes: E880-E888). Relative to regimens of 0-1 medications, regimens including 4 or more prescription medications were significantly associated with an increased risk of falls [4-5 medications adjusted HR 1.22 (1.04, 1.43), 6-7 medications 1.33 (1.12, 1.58), >7 medications 1.59 (1.34, 1.89)]. None of the individual glucose-lowering medications was found to be significantly associated with a higher risk of falls in predictive models.


The prescription of four or more medications was associated with an increased risk of falls among adult diabetes patients, while no specific glucose-lowering agent was linked to increased risk. Baseline risk of falls and number of baseline medications are additional factors to consider when deciding whether to intensify diabetes treatments.


falls polypharmacy insulin geriatrics 


Conflict of Interest

None disclosed.


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Copyright information

© Society of General Internal Medicine 2009

Authors and Affiliations

  • Elbert S. Huang
    • 1
    • 4
  • Andrew J. Karter
    • 2
  • Kirstie K. Danielson
    • 3
  • E. Margaret Warton
    • 2
  • Ameena T. Ahmed
    • 2
  1. 1.Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Kaiser Permanente Division of ResearchOaklandUSA
  3. 3.Institute for Endocrine Discovery and Clinical CareUniversity of ChicagoChicagoUSA
  4. 4.ChicagoUSA

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