Association Between History of Severe Hypoglycemia and Risk of Falls in Younger and Older Patients With Diabetes.
To compare the incidence and relative risk of falls between adults with and without diabetes, and to prospectively assess the role of history of severe hypoglycemia in the putative relationship between diabetes and falls in younger and older people, respectively.The National Health Insurance Research Database in Taiwan was used in this cohort study. Diabetic cases (with and without history of severe hypoglycemia) and nondiabetic people were followed from 2000 to 2009. There were 31,049 people enrolled in each of the 3 groups. Subdistribution hazard ratio (sHR) of falls was estimated with considering death as a competing risk by using Fine and Gray method. Demographic characteristics, diabetes-related complications, and comorbidities associated with falls were adjusted in multivariable Cox regression model.As compared to nondiabetic people, adjusted sHR was 1.13 for diabetes without history of severe hypoglycemia (DwoH) and 1.63 for diabetes with history of severe hypoglycemia (DwH), respectively. DwH group was associated with a higher risk than DwoH (adjusted sHR = 1.57). All of the excessive risks were more pronounced in people younger than 65 years old than in older people.Patients with diabetes had increased risk of falls. Severe hypoglycemia was further associated with a higher risk in diabetes, the increased hazards were particularly pronounced in people younger than 65 years old. Because falls in younger people may result in a greater economic and social loss, our study call for proper attentions to prevention of falls in younger patients (<65 years old) with diabetes.
From Department of Public Health, Medical College, National Cheng-Kung University, Tainan, Taiwan (C-LL, P-CH, H-NS, Y-HC, C-YL); Department of Internal Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan (P-CH); Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan (H-NS); Department of Endocrinology, Far Eastern Memorial Hospital, Panchiao, New Taipei City, Taiwan (H-FC); and Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan (C-YL).
Chin-Li
CL
Lu
Pei-Chun
PC
Hsu
Hsiu-Nien
HN
Shen
Ya-Hui
YH
Chang
Hua-Fen
HF
Chen
Chung-Yi
CY
Li
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000367:Age Factors; D000368:Aged; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology