Vinik Aaron I, Camacho Pauline, Reddy Sethu, Valencia Willy M, Trence Dace, Matsumoto Alvin M, Morley John E
Endocr Pract. 2017 Sep;23(9):1117-1139. doi: 10.4158/EP171794.RA. Epub 2017 Jul 13.
KEY POINTS Falls are a major health issue for older adults, leading to adverse events and even death. Older persons with type 2 diabetes are at increased risk of falling compared to healthy adults of a similar age. Over 400 factors are associated with falls risk, making identification and targeting of key factors to prevent falls problematic. However, the major risk factors include hypertension, diabetes, pain, and polypharmacy. In addition to age and polypharmacy, diabetes-related loss of strength, sensory perception, and balance secondary to peripheral neuropathy along with decline in cognitive function lead to increased risk of falling. Designing specific interventions to target strength and balance training, reducing polypharmacy to improve cognitive function, relaxation of diabetes management to avoid hypoglycemia and hypotension, and relief of pain will produce the greatest benefit for reducing falls in older persons with diabetes. Abbreviation: DPN = diabetic polyneuropathy.
跌倒对老年人来说是一个重大的健康问题，会导致不良事件甚至死亡。与年龄相仿的健康成年人相比，2型糖尿病老年人跌倒的风险更高。超过400个因素与跌倒风险相关，这使得识别和针对关键因素预防跌倒变得困难。然而，主要风险因素包括高血压、糖尿病、疼痛和多重用药。除了年龄和多重用药外，糖尿病相关的力量丧失、感觉知觉以及外周神经病变继发的平衡问题，再加上认知功能下降，都会导致跌倒风险增加。设计针对力量和平衡训练的特定干预措施、减少多重用药以改善认知功能、放宽糖尿病管理以避免低血糖和低血压以及缓解疼痛，将对减少糖尿病老年人的跌倒产生最大益处。缩写：DPN = 糖尿病性多发性神经病变
