Archives of Osteoporosis

, 13:66 | Cite as

Severe hypoglycemia is associated with high risk for falls in adults with type 1 diabetes

  • Viral N Shah
  • Mengdi WuEmail author
  • Nicole Foster
  • Ruban Dhaliwal
  • Mona Al Mukaddam
Short Communication



We evaluated fall frequency and factors affecting falls among middle-aged and older adults with type 1 diabetes (T1D) from T1D Exchange Registry. Twenty-nine percent of T1D participants reported falls within the past 12 months. Severe hypoglycemia, diabetic peripheral neuropathy, and depression were associated with falls in adults with T1D.


Fall is an important risk factor for osteoporotic fracture; we evaluated fall frequency and factors affecting falls among middle-aged and older adults with type 1 diabetes (T1D).


Participants aged ≥ 55 years with T1D completed an email-based questionnaire on falls in the prior 12 months. Demographic, clinical, and fall-related information were gathered from the questionnaire; HbA1c was recorded from medical record data extraction.


Four hundred and thirty five adults with T1D completed the fall questionnaire (mean age 64 ± 7 years, 57% females, and 97% were non-Hispanic whites). The mean diabetes duration was 36 years with mean HbA1c of 7.3%. Among the 435 participants, 126 reported at least one fall in the prior 12 months (29%). The fall frequency values in adults (55–64 years) with T1D and older adults (> 65 years) were 26 and 32%, respectively (p = 0.16). There was no significant difference in frequency of fall between female and male participants (31 vs. 26%, p = 0.33). Of 126 participants who had a fall, 44% had injuries due to fall, 24% required medical attention, and 13 participants reported fracture (10%). Severe hypoglycemia (odds ratio (OR) 3.6), diabetic peripheral neuropathy (OR 2.2), and depression (OR 1.7) were associated with falls in adults with T1D. Forty-one percent of participants were fearful of falls.


This is the first study on prevalence and risk factors for falls suggesting that falls are common in T1D and severe hypoglycemia is a unique diabetes-related factor associated with threefold higher risk for falls.


Epidemiology Falls Type 1 diabetes Fracture prevention Hypoglycemia 


Author contribution

VNS contributed to data interpretation and wrote/edited the manuscript. MW performed statistical analyses and wrote/edited the manuscript. NF, RD, and MAM contributed to data interpretation and reviewed/edited the manuscript.

Compliance with ethical standards

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Viral N Shah
    • 1
  • Mengdi Wu
    • 2
    Email author
  • Nicole Foster
    • 2
  • Ruban Dhaliwal
    • 3
  • Mona Al Mukaddam
    • 4
  1. 1.Barbara Davis Center for DiabetesUniversity of Colorado Anschutz Medical CampusAuroraUSA
  2. 2.Jaeb Center for Health ResearchTampaUSA
  3. 3.SUNY Upstate Medical UniversitySyracuseUSA
  4. 4.University of Pennsylvania Perelman School of MedicinePhiladelphiaUSA

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