Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, 1775 Aurora Ct, Aurora, CO, 80045, USA.
Jaeb Center for Health Research, 15310 Amberly Dr, Suite 350, Tampa, FL, 33647, USA.
Arch Osteoporos. 2018 Jun 12;13(1):66. doi: 10.1007/s11657-018-0475-z.
We evaluated fall frequency and factors affecting falls among middle-aged and older adults with type 1 diabetes (T1D) from T1D Exchange Registry. Twenty-nine percent of T1D participants reported falls within the past 12 months. Severe hypoglycemia, diabetic peripheral neuropathy, and depression were associated with falls in adults with T1D.
Fall is an important risk factor for osteoporotic fracture; we evaluated fall frequency and factors affecting falls among middle-aged and older adults with type 1 diabetes (T1D).
Participants aged ≥ 55 years with T1D completed an email-based questionnaire on falls in the prior 12 months. Demographic, clinical, and fall-related information were gathered from the questionnaire; HbA1c was recorded from medical record data extraction.
Four hundred and thirty five adults with T1D completed the fall questionnaire (mean age 64 ± 7 years, 57% females, and 97% were non-Hispanic whites). The mean diabetes duration was 36 years with mean HbA1c of 7.3%. Among the 435 participants, 126 reported at least one fall in the prior 12 months (29%). The fall frequency values in adults (55-64 years) with T1D and older adults (> 65 years) were 26 and 32%, respectively (p = 0.16). There was no significant difference in frequency of fall between female and male participants (31 vs. 26%, p = 0.33). Of 126 participants who had a fall, 44% had injuries due to fall, 24% required medical attention, and 13 participants reported fracture (10%). Severe hypoglycemia (odds ratio (OR) 3.6), diabetic peripheral neuropathy (OR 2.2), and depression (OR 1.7) were associated with falls in adults with T1D. Forty-one percent of participants were fearful of falls.
This is the first study on prevalence and risk factors for falls suggesting that falls are common in T1D and severe hypoglycemia is a unique diabetes-related factor associated with threefold higher risk for falls.
跌倒（fall）是骨质疏松性骨折的一个重要危险因素；我们评估了中年和老年 1 型糖尿病（T1D）患者的跌倒频率和影响跌倒的因素。
年龄≥55 岁、患有 T1D 的参与者完成了一项关于过去 12 个月内跌倒情况的电子邮件问卷调查。问卷调查收集了人口统计学、临床和与跌倒相关的信息；从病历数据提取中记录了糖化血红蛋白（HbA1c）值。
435 名患有 T1D 的成年人完成了跌倒问卷（平均年龄 64±7 岁，57%为女性，97%为非西班牙裔白人）。平均糖尿病病程为 36 年，平均 HbA1c 为 7.3%。在 435 名参与者中，126 名报告在过去 12 个月内至少发生过一次跌倒（29%）。患有 T1D 的成年人（55-64 岁）和老年人（>65 岁）的跌倒频率值分别为 26%和 32%（p=0.16）。女性和男性参与者的跌倒频率无显著差异（31%比 26%，p=0.33）。在 126 名跌倒的参与者中，44%因跌倒受伤，24%需要医疗照顾，13 名参与者报告骨折（10%）。严重低血糖（OR 3.6）、糖尿病周围神经病变（OR 2.2）和抑郁（OR 1.7）与 T1D 成人的跌倒有关。41%的参与者害怕跌倒。
这是第一项关于 1 型糖尿病患者跌倒发生率和危险因素的研究，表明跌倒在 T1D 中很常见，严重低血糖是与跌倒风险增加三倍相关的独特糖尿病相关因素。
