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

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Abstract

Summary

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.

Purpose

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).

Methods

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.

Results

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.

Conclusions

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.

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Author information

Authors and Affiliations

  1. Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, 1775 Aurora Ct, Aurora, CO, 80045, USA

    Viral N Shah

  2. Jaeb Center for Health Research, 15310 Amberly Dr, Suite 350, Tampa, FL, 33647, USA

    Mengdi Wu & Nicole Foster

  3. SUNY Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA

    Ruban Dhaliwal

  4. University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Mona Al Mukaddam

Authors
  1. Viral N Shah
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  2. Mengdi Wu
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  3. Nicole Foster
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  4. Ruban Dhaliwal
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  5. Mona Al Mukaddam
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Contributions

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.

Corresponding author

Correspondence to Mengdi Wu.

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Shah, V.N., Wu, M., Foster, N. et al. Severe hypoglycemia is associated with high risk for falls in adults with type 1 diabetes. Arch Osteoporos 13, 66 (2018). https://doi.org/10.1007/s11657-018-0475-z

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  • DOI: https://doi.org/10.1007/s11657-018-0475-z

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