Falls as a complication of diabetes mellitus in older people

Abstract

Objectives The aims of this study were to determine the incidence of falls in a group of elderly patients with diabetes and to assess for the prevalence of risk factors for falls in this population. Design This is a population-based study with questionnaire-based interviews. Setting The setting for this study was the London District General Hospital outpatient department. Participants Seventy-seven patients with diabetes, aged over 65 years, randomly selected whilst attending for general diabetic annual review. Patients with dementia, blindness, and immobility and those who were unable to give informed consent were excluded from this study. Measurements The incidence of falls in the last 12 months was used. Information was collected on the incidence of hypoglycaemic episodes, the presence of other medical conditions, visual impairment, and peripheral neuropathy, the use of medications and walking aids, and HbA1C and blood pressure control. Results The incidence of falls was 39%. Falls occurred more frequently in female patients and patients of increasing age. Falls occurred more frequently in patients with poor diabetic control [risk ratio (RR)=7.83 (2.948–20.799), χ 2 value=6.422]; patients requiring assistance with mobility: for those mobile with a stick [RR=1.839 (1.048–3.227), χ 2=4.619]; and those who had previously suffered a stroke [RR=1.929 (1.143–3.257), χ 2 = 4.615]. Conclusion We provide evidence that poorly controlled diabetes and conditions associated with complications of diabetes are associated with an increased risk of falling in older people. We recommend early recognition of the multiple causes of falls in the older diabetic patient and prompt referral of this group of patients to a specialist falls clinic.