Details:

Alternative Title:
Diabetes Care
Publisher's site:
http://dx.doi.org/10.2337/dc13-0429
Personal Author:
Yau, Rebecca K. ; Strotmeyer, Elsa S. ; Resnick, Helaine E. ; Sellmeyer, Deborah E. ; Feingold, Kenneth R. ; ... More +
Yau, Rebecca K. ; Strotmeyer, Elsa S. ; Resnick, Helaine E. ; Sellmeyer, Deborah E. ; Feingold, Kenneth R. ; Cauley, Jane A. ; Vittinghoff, Eric ; De Rekeneire, Nathalie ; Harris, Tamara B. ; Nevitt, Michael C. ; Cummings, Steven R. ; Shorr, Ronald I. ; Schwartz, Ann V. Less -
Description:
OBJECTIVE

To determine whether older adults with diabetes are at increased risk of an injurious fall requiring hospitalization.

RESEARCH DESIGN AND METHODS

The longitudinal Health, Aging, and Body Composition Study included 3,075 adults aged 70–79 years at baseline. Hospitalizations that included ICD-9-Clinical Modification codes for a fall and an injury were identified. The effect of diabetes with and without insulin use on the rate of first fall-related injury hospitalization was assessed using proportional hazards models.

RESULTS

At baseline, 719 participants had diabetes, and 117 of them were using insulin. Of the 293 participants who were hospitalized for a fall-related injury, 71 had diabetes, and 16 were using insulin. Diabetes was associated with a higher rate of injurious fall requiring hospitalization (hazard ratio [HR] 1.48 [95% CI 1.12–1.95]) in models adjusted for age, race, sex, BMI, and education. In those participants using insulin, compared with participants without diabetes, the HR was 3.00 (1.78–5.07). Additional adjustment for potential intermediaries, such as fainting in the past year, standing balance score, cystatin C level, and number of prescription medications, accounted for some of the increased risk associated with diabetes (1.41 [1.05–1.88]) and insulin-treated diabetes (2.24 [1.24–4.03]). Among participants with diabetes, a history of falling, poor standing balance score, and A1C level ≥8% were risk factors for an injurious fall requiring hospitalization.

CONCLUSIONS

Older adults with diabetes, in particular those using insulin, are at greater risk of an injurious fall requiring hospitalization than those without diabetes. Among those with diabetes, poor glycemic control may increase the risk of an injurious fall.


Subjects:
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Accidental Falls Aged Age Factors Blood Glucose Body Composition Diabetes Mellitus Female Follow-Up Studies Hospitalization Humans Incidence Male Prevalence Prognosis Prospective Studies Risk Assessment Risk Factors Wounds And Injuries
Source:
Diabetes Care. 2013; 36(12):3985-3991.
Pubmed ID:
24130352
Pubmed Central ID:
PMC3836123
Document Type:
Journal Article
Funding:
5U38HM000414/HM/NCHM CDC HHS/United States ; N01-AG-6-2101/AG/NIA NIH HHS/United States ; N01-AG-6-2103/AG/NIA NIH HHS/United States ; N01-AG-6-2106/AG/NIA NIH HHS/United States ; R01 AG028050/AG/NIA NIH HHS/United States ; ... More +
5U38HM000414/HM/NCHM CDC HHS/United States ; N01-AG-6-2101/AG/NIA NIH HHS/United States ; N01-AG-6-2103/AG/NIA NIH HHS/United States ; N01-AG-6-2106/AG/NIA NIH HHS/United States ; R01 AG028050/AG/NIA NIH HHS/United States ; R01-AG028050/AG/NIA NIH HHS/United States ; R01-NR012459/NR/NINR NIH HHS/United States ; R21 DK064597/DK/NIDDK NIH HHS/United States Less -
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:80908a4228ffd4c751c6cc2eec22a540b91554f5a24f0545726d768f974b1876
Download URL:
https://stacks.cdc.gov/view/cdc/27866/cdc_27866_DS1.pdf
File Type:

Supporting Files

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