title: The association between glucose metabolism status, diabetes severity and a history of fractures and recent falls in participants of 50 years and older-the Maastricht Study.
abstract: In this cohort of relatively young and well-treated participants with type 2 diabetes, we found no association between diabetes status and a history of previous fractures and recent falls. Furthermore, no association between diabetes severity and previous fractures or recent falls was found.
  
  
  
  In this study, we examined the association between glucose metabolism status and historical fractures or recent falls and the effect of diabetes severity (glucose control, insulin use, and diabetes duration) on falls and fractures in the participants with type 2 diabetes.
  
  
  
  Cross-sectional data from 2005 participants of the Maastricht Study. Falls in the past 6 months and fractures ≥age 50 were assessed by questionnaire. Glucose metabolism status (normal glucose metabolism, impaired glucose metabolism, or type 2 diabetes) was based on the oral glucose tolerance test and medication use.
  
  
  
  In the completely adjusted model, the odds for a fall were not significantly higher in those with impaired glucose metabolism status (OR (95%CI) 1.28 (0.93-1.77)) or with type 2 diabetes (OR (95%CI) 1.21 (0.80-1.81)) compared with the group with normal glucose metabolism. Within the group with type 2 diabetes, there were no significant differences with regard to reported falls between participants with HbA1c >7 % (53 mmol/mol) versus HbA1c ≤7 % (OR (95%CI) 1.05 (0.58-1.90)), insulin users versus non-insulin users (OR (95%CI) 1.51 (0.79-2.89)), and with a diabetes duration >5 versus ≤5 years (OR (95%CI) 0.52 (0.46-1.47)). Similarly, neither glucose metabolism status nor diabetes severity was associated with prior fractures.
  
  
  
  Glucose metabolism status was not significantly associated with previous fractures and recent falls. In addition, in this cohort of relatively young and well-treated participants with type 2 diabetes, diabetes severity was not associated with previous fractures and recent falls.
authors.affiliation: Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University, Maastricht, The Netherlands. e.dewaard@maastrichtuniversity.nl.|NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. e.dewaard@maastrichtuniversity.nl.
authors.forename: E A C
authors.initials: EAC
authors.lastname: de Waard
authors.affiliation: Department of Social Medicine, Maastricht University, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Koster
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.|Department of Human Movement Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Melai
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.|Department of Family Medicine, Maastricht University, Maastricht, The Netherlands.
authors.forename: T A
authors.initials: TA
authors.lastname: van Geel
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.|CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: R M A
authors.initials: RMA
authors.lastname: Henry
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.|CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: M T
authors.initials: MT
authors.lastname: Schram
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.|CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, The Netherlands.|Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
authors.forename: P C
authors.initials: PC
authors.lastname: Dagnelie
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.|CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: C J
authors.initials: CJ
authors.lastname: van der Kallen
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.|CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: S J S
authors.initials: SJS
authors.lastname: Sep
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.|CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: C D A
authors.initials: CDA
authors.lastname: Stehouwer
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.|Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.|CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: N C
authors.initials: NC
authors.lastname: Schaper
authors.affiliation: MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.|Department of Psychiatry and Neurophysiology, Maastricht University, Maastricht, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Köhler
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.|Department of Human Movement Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: H H C M
authors.initials: HHCM
authors.lastname: Savelberg
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.|Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands.|Biomedical Research Institute, University of Hasselt, Hasselt, Belgium.
authors.forename: P P M M
authors.initials: PPMM
authors.lastname: Geusens
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.|Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands.|Department of Internal Medicine, Subdivision of Endocrinology, VieCuri Medical Center, Venlo, The Netherlands.
authors.forename: J P W
authors.initials: JPW
authors.lastname: van den Bergh
mesh_terms: D000058:Accidental Falls; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Diabetes severity; Falls; Fractures; Type 2 diabetes mellitus