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

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DOI

  • Karolina Snopek Khan
  • Diana Hedevang Christensen
  • Sia Kromann Nicolaisen
  • Sandra Sif Gylfadottir
  • Troels Staehelin Jensen
  • Jens Steen Nielsen, The International Diabetic Neuropathy Consortium, Aarhus University Hospital, Aarhus, Denmark., The Danish Centre for Strategic Research in Type, Steno Diabetes Center Odense, Odense University Hospital, From the Heart Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark., Research Unit of SDCO, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Jutland, Sønderborg, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Hospital of Southern Jutland, University Hospital of Southern Denmark, Aabenraa, Denmark. Electronic address: Jprimdahl@danskgigthospital.dk.
  • ,
  • Reimar Wernich Thomsen
  • Henning Andersen

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.

OriginalsprogEngelsk
TidsskriftJournal of Diabetes Investigation
ISSN2040-1116
DOI
StatusE-pub ahead of print - 8 mar. 2021

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