Falls and fractures associated with type 2 diabetic polyneuropathy; a cross-sectional nationwide questionnaire study

TY - JOUR

T1 - Falls and fractures associated with type 2 diabetic polyneuropathy; a cross-sectional nationwide questionnaire study

AU - Khan, Karolina Snopek

AU - Christensen, Diana Hedevang

AU - Nicolaisen, Sia Kromann

AU - Gylfadottir, Sandra Sif

AU - Jensen, Troels Staehelin

AU - Nielsen, Jens Steen

AU - Thomsen, Reimar Wernich

AU - Andersen, Henning

N1 - This article is protected by copyright. All rights reserved.

PY - 2021/10

Y1 - 2021/10

N2 - AIM: To examine the prevalence of falls and fractures and the association with symptoms of diabetic polyneuropathy (DPN) in patients with recently diagnosed type 2 diabetes.RESEARCH DESIGN AND METHODS: A detailed questionnaire on neuropathy symptoms and falls was sent to 6,726 patients enrolled in the DD2 cohort (median age 65 years, diabetes duration 4.6 years). Complete data on fractures and patient characteristics were ascertained from population-based health registries. We defined possible DPN as a score ≥4 on the Michigan Neuropathy Screening Instruments questionnaire (MNSIq). Using Poisson regression analyses, we estimated the adjusted prevalence ratio (aPR) of falls and fractures, comparing patients with and without DPN.RESULTS: In total, 5,359 (80%) answered the questions on MNSIq and falls. Within the year preceding questionnaire-response, 17% (n=933) reported at least one fall and 1.4% (n=76) suffered from a fracture. The prevalence ratio of falls was substantially increased in patients with possible DPN compared to those without: aPR: 2.33 (95% confidence interval [CI] 2.06-2.63). The prevalence ratio increased with the number of falls from aPR: 1.51 (95% CI: 1.22-1.89) for one fall to aPR: 5.89 (95% CI: 3.84-9.05) for ≥4 falls within the preceding year. Possible DPN was associated with a slightly although non-significantly increased risk of fractures: aPR: 1.32 (95% CI: 0.75-2.33).CONCLUSIONS: Patients with recently diagnosed type 2 diabetes and symptoms of DPN had a highly increased risk of falling. These results emphasize the need for preventive interventions to reduce fall risk among patients with type 2 diabetes and possible DPN.

AB - AIM: To examine the prevalence of falls and fractures and the association with symptoms of diabetic polyneuropathy (DPN) in patients with recently diagnosed type 2 diabetes.RESEARCH DESIGN AND METHODS: A detailed questionnaire on neuropathy symptoms and falls was sent to 6,726 patients enrolled in the DD2 cohort (median age 65 years, diabetes duration 4.6 years). Complete data on fractures and patient characteristics were ascertained from population-based health registries. We defined possible DPN as a score ≥4 on the Michigan Neuropathy Screening Instruments questionnaire (MNSIq). Using Poisson regression analyses, we estimated the adjusted prevalence ratio (aPR) of falls and fractures, comparing patients with and without DPN.RESULTS: In total, 5,359 (80%) answered the questions on MNSIq and falls. Within the year preceding questionnaire-response, 17% (n=933) reported at least one fall and 1.4% (n=76) suffered from a fracture. The prevalence ratio of falls was substantially increased in patients with possible DPN compared to those without: aPR: 2.33 (95% confidence interval [CI] 2.06-2.63). The prevalence ratio increased with the number of falls from aPR: 1.51 (95% CI: 1.22-1.89) for one fall to aPR: 5.89 (95% CI: 3.84-9.05) for ≥4 falls within the preceding year. Possible DPN was associated with a slightly although non-significantly increased risk of fractures: aPR: 1.32 (95% CI: 0.75-2.33).CONCLUSIONS: Patients with recently diagnosed type 2 diabetes and symptoms of DPN had a highly increased risk of falling. These results emphasize the need for preventive interventions to reduce fall risk among patients with type 2 diabetes and possible DPN.

KW - Diabetic polyneuropathy

KW - Falls

KW - Fractures

UR - http://www.scopus.com/inward/record.url?scp=85104330995&partnerID=8YFLogxK

U2 - 10.1111/jdi.13542

DO - 10.1111/jdi.13542

M3 - Journal article

C2 - 33686761

SN - 2040-1116

VL - 12

SP - 1827

EP - 1834

JO - Journal of Diabetes Investigation

JF - Journal of Diabetes Investigation

IS - 10

ER -