PMID- 26492544
OWN - NLM
STAT- MEDLINE
DCOM- 20160729
LR  - 20210204
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
VI  - 22
IP  - 2
DP  - 2016 Feb
TI  - ASSOCIATION BETWEEN HYPOGLYCEMIA AND FALL-RELATED FRACTURES AND HEALTH CARE 
      UTILIZATION IN OLDER VETERANS WITH TYPE 2 DIABETES.
PG  - 196-204
LID - 10.4158/EP15640.OR [doi]
AB  - OBJECTIVE: To examine the association between hypoglycemia and fall-related 
      outcomes in older patients with type 2 diabetes mellitus (T2DM). METHODS: This 
      retrospective cohort study used electronic medical records of T2DM patients (>/=65 
      years) from the Veterans Integrated Service Network 16 (VISN 16) data warehouse 
      (01/01/2004-06/30/2010). Patients in nonhypoglycemia group (non-HG) were 1:1 
      randomly matched with patients in hypoglycemia group (HG) by age (+/-5 years), sex, 
      race, and medical center location. Fall-related events (i.e., fractures and head 
      injuries) were identified, with a fall being the external cause within +/-2 days. 
      McNemar tests and generalized estimating equation (GEE) models were used to 
      compare fall-related events in the 1-year outcome period after the index date 
      (i.e., date of first hypoglycemic episode). We also examined fall-related 
      healthcare utilization. RESULTS: A total of 4,215 patients in each group were 
      studied, with the mean age of 76.5 years (SD: 5.85). The mean Charlson 
      comorbidity index (CCI) scores were 5.73 (SD: 2.95) in the HG and 4.34 (SD: 2.40) 
      in the non-HG. The HG had significantly higher rates of fall-related events than 
      non-HG, 27 (0.64%) versus 1 (0.02%) and 89 (2.11%) versus 21 (0.50%) events 
      within 30 days and 1 year, respectively. GEE models confirmed the elevated risk 
      of fall-related events after controlling for sociodemographic and clinical 
      characteristics, comorbidities, and medication use (adjusted odds ratio [aOR]: 
      2.70; 95% confidence interval [CI]: 1.64-4.47). The HG patients were more likely 
      to have emergency department (ED) visits, hospital admissions, and long-term care 
      placement compared to their counterparts. CONCLUSION: Hypoglycemia is associated 
      with worse fall-related outcomes among the elderly veterans.
FAU - Zhao, Yingnan
AU  - Zhao Y
FAU - Kachroo, Sumesh
AU  - Kachroo S
FAU - Kawabata, Hugh
AU  - Kawabata H
FAU - Colilla, Susan
AU  - Colilla S
FAU - Mukherjee, Jayanti
AU  - Mukherjee J
FAU - Fonseca, Vivian
AU  - Fonseca V
FAU - Iloeje, Uchenna
AU  - Iloeje U
FAU - Shi, Lizheng
AU  - Shi L
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20151022
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
SB  - IM
MH  - Accidental Falls/*statistics & numerical data
MH  - Aged
MH  - Aged, 80 and over
MH  - Case-Control Studies
MH  - Diabetes Mellitus, Type 2/complications/*epidemiology
MH  - Female
MH  - Fractures, Bone/*epidemiology/etiology
MH  - Health Resources/*statistics & numerical data
MH  - Humans
MH  - Hypoglycemia/complications/*epidemiology
MH  - Male
MH  - Retrospective Studies
MH  - United States/epidemiology
MH  - Veterans/*statistics & numerical data
EDAT- 2015/10/23 06:00
MHDA- 2016/07/30 06:00
CRDT- 2015/10/23 06:00
PHST- 2015/10/23 06:00 [entrez]
PHST- 2015/10/23 06:00 [pubmed]
PHST- 2016/07/30 06:00 [medline]
AID - S1530-891X(20)39280-6 [pii]
AID - 10.4158/EP15640.OR [doi]
PST - ppublish
SO  - Endocr Pract. 2016 Feb;22(2):196-204. doi: 10.4158/EP15640.OR. Epub 2015 Oct 22.