Severe hypoglycemia raises fall risk in older adults with T2D

  • Lee AK & al.
  • Diabetes Care
  • 01.07.2020

  • von Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Severe hypoglycemia is associated with substantially increased fall risk in older adults with type 2 diabetes (T2D).
  • Fall risk should be considered when individualizing glycemic treatment.

Why this matters

  • Falls and fractures increase morbidity and mortality in older adults.

Study design

  • Prospective cohort analysis of claims data for 1162 participants from the Atherosclerosis Risk in Communities study (ages, 45-64 years in 1987) with diagnosed diabetes at visit 4 (1996-1998), followed through 2013.
  • Funding: NIH.

Key results

  • During follow-up, 135 had severe hypoglycemia and 334 falls occurred.
  • Crude fall incidence rates per 100 person-years were 8.81 (95% CI, 6.73-11.53) and 2.17 (95% CI, 1.93-2.44) for those with and without severe hypoglycemia, respectively.
  • After adjustment for age, sex, and race, incidence rate ratios (95% CI) for those with vs without severe hypoglycemia:
    • Any fall: 3.11 (2.29-4.24).
    • Hospitalized fall: 2.75 (1.78-4.27).
    • Fall with a fracture: 2.15 (1.33-3.48).

Limitations

  • Reliance on claims data, including for severe hypoglycemia reporting.
  • No accounting for changing variables over time, including diabetes medication use and complications.
  • Cannot prove hypoglycemia contributed to all falls.