@article{ref1,
title="Association between hypoglycemia and fall-related fractures and health care utilization in older veterans with type 2 diabetes",
journal="Endocrine practice",
year="2015",
author="Zhao, Yingnan and Kachroo, Sumesh and Kawabata, Hugh and Colilla, Susan and Mukherjee, Jayanti and Fonseca, Vivian and Iloeje, Uchenna and Shi, Lizheng",
volume="22",
number="2",
pages="196-204",
abstract="OBJECTIVE: To examine the association between hypoglycemia and fall-related outcomes in older patients with type 2 diabetes mellitus (T2DM). <br><br>METHODS: This retrospective cohort study used electronic medical records of T2DM patients ( 65 years) from the VISN 16 data warehouse (01/01/2004-06/30/2010). Patients in non-hypoglycemia group (Non-HG) were 1:1 randomly matched with patients in hypoglycemia group (HG) by age (+/−5 years), gender, 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 one-year outcome period after the index date (i.e., date of first hypoglycemic episode). We also examined fall-related health care utilization. <br><br>RESULTS: A total of 4,215 patients in each group were studied, with the mean age of 76.5 years (SD: 5.85). Charlson Comorbidity Index (CCI) was 5.73 (SD: 2.95) in the HG and 4.34 (SD: 2.40) in the non-HG. HG had significantly higher rates of fall-related events than non-HG, 27 (0.64%) versus one event (0.02%) and 89 (2.11%) versus 21 events (0.50%) within 30 days and one year, respectively. GEE models confirmed the elevated risk of fall-related events after controlling for social-demographic and clinical characteristics, comorbidities, and use of medication (adjusted odds ratio [aOR]: 2.70; 95% CI: 1.64-4.47). The HG patients were more likely to have emergency department visits, hospital admissions and long-term care placement compared to their counterparts. <br><br>CONCLUSION: Hypoglycemia is associated with worse fall-related outcomes among the elderly veterans.<p /> <p>Language: en</p>",
language="en",
issn="1530-891X",
doi="10.4158/EP15640.OR",
url="http://dx.doi.org/10.4158/EP15640.OR"
}