EASD 2020 — Diabetes associated with high risk for falls, fracture


  • Deepa Koli
  • Conference Reports
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Takeaway

  • Patients with diabetes show an increased risk for first falls and fall-related injuries including fractures.
  • Sex, age, selective serotonin reuptake inhibitor (SSRI) and opioid use, and history of alcohol abuse are significant risk factors for fracture.

Why this matters

  • Findings can guide treatment choices in patients at high risk for fracture and falls.

Study design

  • Study of 12,975 patients with type 1 and 407,009 patients with type 2 diabetes from the Danish National Patient Register and age-and sex-matched control individuals.
  • Funding: None disclosed.

Key results

  • The cumulative incidence of falls requiring hospital treatment was 13.3% and 11.9% in people with type 1 and 2 diabetes, respectively.
  • Risk for first fall was significantly higher in patients with
    • Type 1 diabetes: aHR, 1.33 (95% CI, 1.25-1.43).
    • Type 2 diabetes: aHR, 1.19 (95% CI, 1.16-1.22).
  • Significant risk factors of falls in patients with type 1 and 2, respectively, were:
    • Women: HR, 1.21 and 1.61 (both P<.001>
    • Age >65 years: HR, 1.52 and 1.32 (both P<.001>
    • SSRI use: HR, 1.35 and 1.32 (both P<.001>
    • Opioid use: 1.15 and 1.09 (both P<.001>
    • History of alcohol abuse: HR, 1.77 (P=.006) and 1.88 (P<.001>
  • Patients with type 1 diabetes had a higher incidence of:
    • Hip and femoral fractures (incidence rate ratio [IRR], 1.11; 95% CI, 1.11-1.23).
  • People with type 2 diabetes showed higher risk for fractures at:
    • Hip (IRR, 1.02; 95% CI, 1.02-1.4),
    • Radius (IRR, 1.39; 95% CI, 1.18-1.61),
    • Humerus (IRR, 1.24; 95% CI, 1.12-1.37) and
    • Skull/face (IRR, 1.21; 95% CI, 1.12-1.48).

Limitations

  • Retrospective design.