Bradley R. Horton
BOSTON — Engaging in regular self-management of diabetes may decrease the risk for both falls and fall-related injuries in patients with diabetes and CKD, according to a poster presented at the National Kidney Foundation Spring Clinical Meetings.
“We know that those with diabetes are at an increased risk for falls and those with CKD are also at an increased risk,” Bradley R. Horton, of Ball State University in Indiana, told Healio/Nephrology. “Having these two comorbidities together further increases fall-risk. We sought to determine what factors might decrease this risk.”
Researchers used data from the 2016 Behavioral Risk Factor Surveillance System to conduct a cross-sectional study of 6,505 adults aged 45 years or greater who had both CKD and diabetes. Researchers then used logistic regression models to measure the association between diabetes management behaviors—like glycemic control, physician visits, insulin use, eye exams and exercise— and falls and fall-related-injuries.
Of the entire study population, 50.4% suffered a fall. Of these, 50% reported a fall-related injury.
Researchers found that current insulin use (OR = 0.62; 95% CI, 0.40-0.96) and attending a diabetes self-management class decreased the risk for fall (OR = 0.58; 95% CI, 0.37-0.92).
“Another interesting finding was that self-check of feet for foot sores was associated with decreased risk for fall,” Horton said. “Foot sores are associated with falls because you tend to change your gait and how you walk and it can also affect postural sway which can lead to falls. This finding makes sense because people who are more prone to foot sores are going to check their feet more often.”
Finally, Horton noted that he was initially surprised that, instead of increasing risk for fall and fall-related injuries, participation in physical activity was actually a protective factor. “Exercise can help with bone matrixing so maybe that’s why patients who exercise are at a decreased risk for fall-related injuries and fractures.”
“While we can’t prove any direct cause-and-effect for these behaviors, we see the correlations,” Horton concluded. “More studies, especially randomized control trials, are needed.”– by Melissa J. Webb
Horton B, et al. Diabetes management behaviors are associated with reduced risk of falling among patients with kidney disease. Presented at: National Kidney Foundation Spring Clinical Meetings; May 8-12, 2019; Boston.
Disclosure: Healio/Nephrology was unable to determine relevant financial disclosures prior to publication.