Evidence map›Paper›PMID 32611607›Full record

ArticleDiabetes care2020

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

Alexandra K Lee, Stephen P Juraschek, B Gwen Windham, Clare J Lee, A Richey Sharrett, Josef Coresh, Elizabeth Selvin

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 2 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Alexandra K LeeDivision of Geriatrics, University of California, San Francisco, San Francisco, CA.
Stephen P JuraschekDepartment of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.ORCID 0000-0001-9525-3833
B Gwen WindhamDepartment of Medicine/Geriatric Medicine, University of Mississippi Medical Center, Jackson, MS.
Clare J LeeDivision of Endocrinology, Diabetes and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD.
A Richey SharrettDepartment of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.ORCID 0000-0002-0824-0207
Josef CoreshDepartment of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Elizabeth SelvinDepartment of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD eselvin@jhu.edu.ORCID 0000-0001-6923-7151
Johns Hopkins University · USBeth Israel Deaconess Medical Center · USUniversity of California, San Francisco · USUniversity of Mississippi Medical Center · US

Funding

CARDIOVASCULAR EPIDEMIOLOGY INSTITUTIONAL TRAININGT32HL007024 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Elizabeth Selvin · 1985 to 2026
$17.5M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5U01HL096917 · NHLBI · UNIVERSITY OF MISSISSIPPI MED CTR · PI MOSLEY, THOMAS H · 2010 to 2018
$11.9M
RESEARCH TRAINING IN GERIATRIC MEDICINET32AG000212 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 1991 to 2026
$7.7M
Diabetes and Prediabetes in Older Adults in ARICR01DK089174 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2011 to 2020
$6.4M
Vitamin D, Subclinical Cardiovascular Disease, and Orthostatic Hypotension in Older AdultsK23HL135273 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI JURASCHEK, STEPHEN P · 2017 to 2021
$1.1M
Research and Mentoring in the Clinical Epidemiology of Type 2 DiabetesK24DK106414 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2015 to 2019
$654k
Exploring Mechanisms of Changes in Glucose Homeostasis After Bariatric Surgery: Comparing Vertical Sleeve Gastrectomy and Roux-en-Y Gastric BypassK23DK107921 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI LEE, CLARE JUNG EUN · 2016 to 2018
$582k
NHLBI NIH HHS HHSN268201700001CNHLBI NIH HHS HHSN268201700001INHLBI NIH HHS HHSN268201700002CNHLBI NIH HHS HHSN268201700002INHLBI NIH HHS HHSN268201700003CNHLBI NIH HHS HHSN268201700003INHLBI NIH HHS HHSN268201700004CNHLBI NIH HHS HHSN268201700004INHLBI NIH HHS HHSN268201700005CNHLBI NIH HHS HHSN268201700005INHLBI NIH HHS K23 HL135273NHLBI NIH HHS T32 HL007024NHLBI NIH HHS U01 HL096917NIA NIH HHS T32 AG000212NIDDK NIH HHS K23 DK107921NIDDK NIH HHS K24 DK106414NIDDK NIH HHS R01 DK089174
6 · The paper itself

Abstract

objectiveHypoglycemia 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. RESEARCH DESIGN AND

methodsWe 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 from 1996 to 2013. Secondary analyses examined hospitalized falls and falls with fracture. We calculated incidence rates and used Cox regression models to evaluate the independent association of severe hypoglycemia with falls occurring after visit 4 through 2013.

resultsAmong 1,162 participants with diabetes, 149 ever had a severe hypoglycemic event 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 with 8.81 per 100 PY (6.73-11.53) with severe hypoglycemia. After adjustment, severe hypoglycemia was associated with a more than twofold higher risk of falls (hazard ratio 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.

conclusionsSevere 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.

Indexed as

Accidental FallsAgedBlood GlucoseCohort StudiesDiabetes Mellitus, Type 2FemaleHospitalizationHumansHypoglycemiaHypoglycemic AgentsIncidenceMaleMiddle AgedProspective StudiesRisk FactorsSeverity of Illness IndexBlood GlucoseHypoglycemic Agents

Identifiers

PMID32611607
PMCPMC7440903
OpenAlexW3038597499

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.