posted 12/11/02
Falls are common among
diabetic patients with prior foot ulcers, according to new study.
While few falls results in
fractures, the risk of fall-related fractures is significantly higher in women
than in men.
Dr. Carolyn Wallace, of VA Puget Sound Health
Care System, Seattle, Washington, and colleagues examined the incidence of
falls, the risk factors for falls, and the frequency of fall-related fractures
in 400 diabetic patients with a prior foot ulcer. They collected data on foot
status, functionality and lower-limb sensory perception at baseline, 1 year, and
2 years, and information about falls at baseline, 4 weeks, and every 17 weeks
thereafter.
The patients had an average age of 62 years, and
77% were male. Fixed foot deformities, insensate feet, and comorbid conditions
were observed in 32%, 58%, and 76% of patients, respectively.
The team notes that 252 patients (64%) reported
at least one fall during the 2-year follow-up. The overall incidence of falls
was 1.25 per person-year. One hundred sixty-four patients (41%) reported at
least two falls. Risk factors for two or more falls included a body mass index
of at least 30 kg/m, at least one comorbid condition, and insensate feet.
There were a total of 15 fall-related fractures
during the study. "Fracture risk was significantly higher in women, in
individuals who had diabetes for at least 25 years, and in study participants
who wore their own footwear rather than special study shoes," Dr. Wallace and
colleagues explain.
They suggest that clinicians discuss the risk of falls with diabetic patients and advise on strategies to prevent fall-related injuries.
Source: Diabetes In Control Dot Com: Diabetes Care 2002;25:1983-1986.
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