scholarly journals Severe Hypoglycemia and Risk of Falls in Type 2 Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study

Diabetes Care ◽  
2020 ◽  
Vol 43 (9) ◽  
pp. 2060-2065
Author(s):  
Alexandra K. Lee ◽  
Stephen P. Juraschek ◽  
B. Gwen Windham ◽  
Clare J. Lee ◽  
A. Richey Sharrett ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Severe Hypoglycemia ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Risk Of Falls ◽  
Aric Study

scholarly journals Severe Hypoglycemia and Risk of Falls in Type 2 Diabetes: the Atherosclerosis Risk in Communities (ARIC) Study

2020 ◽  
Author(s):  
Alexandra K. Lee ◽  
Stephen P. Juraschek ◽  
B. Gwen Windham ◽  
Clare J. Lee ◽  
A. Richey Sharrett ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Cohort Analysis ◽  
Severe Hypoglycemia ◽  
Emergency Department Visits ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Risk Of Falls ◽  
Aric Study

<b>Background</b>: Hypoglycemia has been postulated to contribute to falls risk in older adults with type 2 diabetes. However, few studies have prospectively examined the association between severe hypoglycemia and falls, both important causes of morbidity and mortality. <div><p><b>Methods</b>: We conducted a prospective cohort analysis of participants from the Atherosclerosis Risk in Communities (ARIC) Study with diagnosed diabetes at Visit 4 (1996-1998). Episodes of severe hypoglycemia requiring medical treatment were identified using ICD-9 codes from hospitalizations, emergency department visits, and ambulance calls; total falls were identified from medical claims using E-codes (1996-2013). Secondary analyses examined hospitalized falls and falls with fracture. We calculated incidence rates and used Cox regression models to evaluate the independent associations of severe hypoglycemia with falls occurring after Visit 4 through 2013. </p> <p><b>Results</b>: Among 1,162 participants with diabetes, 149 ever had a severe hypoglycemic event, either before baseline or during the median of 13.1 years of follow-up. The crude incidence rate of falls among persons without severe hypoglycemia was 2.17 per 100 person-years (PY) (95%CI: 1.93-2.44), compared to 8.81 per 100PY (6.73-11.53) with severe hypoglycemia. After adjustment, severe hypoglycemia was associated with over twofold higher risk of falls (hazard ratio (HR) 2.23, 95%CI 1.61-3.07). Associations were consistent in subgroups defined by age, sex, race, BMI, duration of diabetes, or functional difficulty. </p> <p><b>Conclusions</b>: Severe hypoglycemia was associated with a substantially higher risk of falls in this community-based population of adults with diabetes. Fall risk should be considered when individualizing glycemic treatment in older adults. Assessing hypoglycemia history and future hypoglycemia risk could also improve multifactorial fall prevention interventions for older adults with diabetes.</p> </div> <br>

scholarly journals Severe Hypoglycemia and Risk of Falls in Type 2 Diabetes: the Atherosclerosis Risk in Communities (ARIC) Study

2020 ◽  
Author(s):  
Alexandra K. Lee ◽  
Stephen P. Juraschek ◽  
B. Gwen Windham ◽  
Clare J. Lee ◽  
A. Richey Sharrett ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Cohort Analysis ◽  
Severe Hypoglycemia ◽  
Emergency Department Visits ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Risk Of Falls ◽  
Aric Study

<b>Background</b>: Hypoglycemia has been postulated to contribute to falls risk in older adults with type 2 diabetes. However, few studies have prospectively examined the association between severe hypoglycemia and falls, both important causes of morbidity and mortality. <div><p><b>Methods</b>: We conducted a prospective cohort analysis of participants from the Atherosclerosis Risk in Communities (ARIC) Study with diagnosed diabetes at Visit 4 (1996-1998). Episodes of severe hypoglycemia requiring medical treatment were identified using ICD-9 codes from hospitalizations, emergency department visits, and ambulance calls; total falls were identified from medical claims using E-codes (1996-2013). Secondary analyses examined hospitalized falls and falls with fracture. We calculated incidence rates and used Cox regression models to evaluate the independent associations of severe hypoglycemia with falls occurring after Visit 4 through 2013. </p> <p><b>Results</b>: Among 1,162 participants with diabetes, 149 ever had a severe hypoglycemic event, either before baseline or during the median of 13.1 years of follow-up. The crude incidence rate of falls among persons without severe hypoglycemia was 2.17 per 100 person-years (PY) (95%CI: 1.93-2.44), compared to 8.81 per 100PY (6.73-11.53) with severe hypoglycemia. After adjustment, severe hypoglycemia was associated with over twofold higher risk of falls (hazard ratio (HR) 2.23, 95%CI 1.61-3.07). Associations were consistent in subgroups defined by age, sex, race, BMI, duration of diabetes, or functional difficulty. </p> <p><b>Conclusions</b>: Severe hypoglycemia was associated with a substantially higher risk of falls in this community-based population of adults with diabetes. Fall risk should be considered when individualizing glycemic treatment in older adults. Assessing hypoglycemia history and future hypoglycemia risk could also improve multifactorial fall prevention interventions for older adults with diabetes.</p> </div> <br>

367-P: Severe Hypoglycemia and Risk of Falls in Type 2 Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 367-P
Author(s):  
ALEXANDRA K. LEE ◽  
STEPHEN P. JURASCHEK ◽  
B. GWEN WINDHAM ◽  
CLARE LEE ◽  
A. RICHEY SHARRETT ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Severe Hypoglycemia ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Risk Of Falls ◽  
Aric Study

scholarly journals Novel Risk Factors and the Prediction of Type 2 Diabetes in the Atherosclerosis Risk in Communities (ARIC) Study

Diabetes Care ◽  
2012 ◽  
Vol 36 (1) ◽  
pp. 70-76 ◽  
Author(s):  
L. A. Raynor ◽  
J. S. Pankow ◽  
B. B. Duncan ◽  
M. I. Schmidt ◽  
R. C. Hoogeveen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Novel Risk Factors ◽  
Aric Study

scholarly journals Serum calcium and incident type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study

2016 ◽  
Vol 104 (4) ◽  
pp. 1023-1029 ◽  
Author(s):  
Mary R Rooney ◽  
James S Pankow ◽  
Shalamar D Sibley ◽  
Elizabeth Selvin ◽  
Jared P Reis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Serum Calcium ◽  
Atherosclerosis Risk In Communities ◽  
Incident Type ◽  
Incident Type 2 Diabetes ◽  
Atherosclerosis Risk ◽  
Aric Study

scholarly journals The association between dietary choline and betaine with the risk of type 2 diabetes: The Atherosclerosis Risk in Communities (ARIC) Study

2020 ◽  
Author(s):  
Daniel T. Dibaba ◽  
Karen C. Johnson ◽  
Anna M. Kucharska-Newton ◽  
Katie Meyer ◽  
Steven H. Zeisel ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
P Value ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Choline Intake ◽  
Aric Study ◽  
Prospective Longitudinal ◽  
Dietary Choline

Objectives: To examine the association between dietary intake of choline and betaine with the <h3>risk of type 2 diabetes.</h3> <h3>Methods: Among 13,440 Atherosclerosis Risk in Communities (ARIC) study participants, the prospective longitudinal association between dietary choline and betaine intake and the risk of type 2 diabetes was assessed using interval censored Cox proportional hazards and logistic regression models adjusted for baseline potential confounding variables.</h3> <h3>Results: Among 13,440 participants (55% women, mean age 54 (SD 7.4) years) 1396 developed incident type 2 diabetes during median follow up of 9 years from 1987 through 1998. There was no statistically significant association between every 1 standard deviation (SD) increase in dietary choline and risk of type 2 diabetes, HR = 1.01 (95% CI:0.87, 1.16), nor between dietary betaine intake and the risk of type 2 diabetes, HR = 1.01 (0.94, 1.10). Those in the highest quartile of dietary choline intake did not have a statistically significant higher risk of type 2 diabetes than those in the lowest choline quartile, HR = 1.09 (0.84, 1.42); similarly, dietary betaine intake was not associated with the risk of type 2 diabetes comparing the highest quartile to the lowest, HR = 1.06 (0.87, 1.29). Among women, there was a higher risk of type 2 diabetes, comparing the highest to lowest dietary choline quartile, HR = 1.54 (1.06, 2.25); while in males the association was null, HR = 0.82 (0.57, 1.17). Nevertheless, there was a non-significant interaction between high choline intake and sex on the risk of type 2 diabetes (<i>P-value </i>= 0.07). The results from logistic regression were similar. </h3> <h3>Conclusion: Overall and among male participants, dietary choline or betaine intakes were not associated with the risk of type 2 diabetes. Among female participants, there was a trend for a modestly higher risk of type 2 diabetes among those with the highest as compared to the lowest quartile of dietary choline intake. Our study should inform clinical trials on dietary choline and betaine supplementation in relationship with the risk of type 2 diabetes. </h3>

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