Risk Factors for Fractures and Falls in Older Women with Type 2 Diabetes Mellitus

Patel, Sanjeev; Hyer, Steve; Tweed, Karen; Kerry, Sally; Allan, Kathryn J.; Rodin, Alvin E.; Barron, Jeffrey

doi:10.1007/s00223-007-9082-5

Cited by 77 publications

(58 citation statements)

References 28 publications

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“…A number of previous studies showed that diabetic neuropathy is a significant risk factor for falling [27][28][29]. It has been suggested that peripheral neuropathy impairs ankle strength, balance recovery, and walking stability in patients with diabetes [28].…”

Section: Discussionmentioning

confidence: 99%

Association between the risk of falls and osteoporotic fractures in patients with type 2 diabetes mellitus

et al. 2017

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FALLING is a major health concern among elderly people because it increases the incidence of fractures and causes a deterioration in mobility. It is reported that one in three people over 65 years of age fall at least once per year and that half of elderly people over 80 years of age experience at least one fall per year [1][2][3]. Moreover, the severity of fall-related complications increases with aging. Fractures are one of the most serious fall-related injuries and can lead to a loss of independence through disability and fear of falling. The reduction in mobility and independence is a serious issue in aging societies because it often results in admission to a hospital or nursing home and can potentially result in premature death. Additionally, diabetes mellitus (DM) is known to be associated with an Department of Medicine, Diabetes, Metabolism and Endocrinology, Matsuyama Red Cross Hospital, Japan Abstract. Diabetes mellitus is associated with an increased risk of falls, which increases the incidence of osteoporotic fractures and accordingly decreases quality of life. However, the association between fall risk and diabetic complications is not completely understood. Therefore, the aim of this study was to examine the association between fall risk and osteoporotic fractures in patients with type 2 diabetes mellitus (T2DM). We enrolled 194 Japanese patients with T2DM and assessed their fall risk using a brief interview form that included five items covering physical and social aspects of functioning and environmental factors. We examined the associations between fall risk and the presence of diabetic complications, such as neuropathy, retinopathy, nephropathy, cardiovascular disease, cerebrovascular disease, peripheral artery disease (PAD), and osteoporotic fractures (including any fracture and vertebral fractures only). In the multivariate logistic regression analysis, a longer history of T2DM, the presence of neuropathy and PAD, and a history of any fractures were significantly and positively associated with the risk of falls. On the other hand, a lower body mass index, the presence of neuropathy, and the risk of falls were independently and positively associated with the risk of any fracture. When fractures were limited to vertebral fractures only, the association with the risk of falls remained significant. We found that the risk of falls and osteoporotic fractures were associated in patients with T2DM and that a brief screening test of the risk of falls was useful for assessing the risk of osteoporotic fractures.Key words: Fall, Osteoporosis, Fracture, Neuropathy, Type 2 diabetes mellitus increased risk of falling [4][5][6]. Therefore, it is no less important to assess the risk of falls in diabetic patients than it is in their non-diabetic counterparts. Osteoporosis has been recognized as one of the complications of DM. Accumulating evidence shows that patients with DM have an increased risk of osteoporotic fractures independently of their bone mineral density (BMD) [7][8][9]. Several meta-analyses ha...

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Section: Discussionmentioning

confidence: 99%

Association between the risk of falls and osteoporotic fractures in patients with type 2 diabetes mellitus

et al. 2017

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“…A number of different mechanisms are considered responsible for this finding, such as peripheral neuropathy, compromised renal function, inadequate glucose control, hypoglycemia, diabetes-related muscle weakness, impaired vision and hearing, and a change in the distribution of body composition 23,24 . We did not study aspects related to sensory or motor peripheral neuropathy, as described by others 24,25 .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for recurrent falls among Brazilian women and men: the Brazilian Osteoporosis Study (BRAZOS)

et al. 2010

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“…Consequently, patients with diabetes have a higher risk of falls because of reduced muscle strength (8,16) and DM-induced-muscle atrophy. Where DM induces skeletal muscle atrophy, fast-twitch fibers are prone to greater atrophy than are slow-twitch fibers (1).…”

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confidence: 99%

Heat stress attenuates skeletal muscle atrophy of extensor digitorum longus in streptozotocin-induced diabetic rats

Nonaka¹,

Une²,

Akiyama³

2015

Acta Physiologica Hungarica

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To investigate whether heat stress attenuates skeletal muscle atrophy of the extensor digitorum longus (EDL) muscle in streptozotocin-induced diabetic rats, 12-week-old male Wistar rats were randomly assigned to four groups (n = 6 per group): control (Con), heat stress (HS), diabetes mellitus (DM), and diabetes mellitus/heat stress (DM + HS). Diabetes was induced by intraperitoneal injection of streptozotocin (50 mg/kg). Heat stress was induced in the HS and DM + HS groups by immersion of the lower half of the body in hot water at 42 °C for 30 min; it was initiated 7 days after injection of streptozotocin, and was performed once a day, five times a week for 3 weeks. The muscle fiber cross-sectional area of EDL muscles from diabetic and non-diabetic rats was determined; heat stress protein (HSP) 72 and HSP25 expression levels were also analyzed by western blotting. Diabetes-induced muscle fiber atrophy was attenuated upon heat stress treatment in diabetic rats. HSP72 and HSP25 expression was upregulated in the DM + HS group compared with the DM group. Our findings suggest that heat stress attenuates atrophy of the EDL muscle by upregulating HSP72 and HSP25 expression.Keywords: extensor digitorum longus muscle, heat stress, HSP72, HSP25, skeletal muscle atrophy, streptozotocin-induced diabetes Diabetes mellitus (DM) induces skeletal muscle atrophy (7, 19) and decreases muscle strength (7, 9). Consequently, patients with diabetes have a higher risk of falls because of reduced muscle strength (8, 16) and DM-induced-muscle atrophy. Where DM induces skeletal muscle atrophy, fast-twitch fibers are prone to greater atrophy than are slow-twitch fibers (1). Fast-twitch fibers are responsible for high force/power/speed production and maintaining physical balance during postural perturbation. Hence, atrophy of fast-twitch muscle increases the risk of falling in DM patients. Therefore, an efficient strategy is required to attenuate muscle atrophy in order to reduce the risk of falls in DM patients. Heat shock proteins (HSPs) have a protective effect on muscle atrophy. Senf et al. reported that HSP70 overexpression prevented rat soleus muscle fiber atrophy induced by hind limb immobilization (18). Furthermore, overexpression of HSP27 also prevented muscle fiber atrophy of the soleus muscle induced by disuse in rats (5). HSPs are expressed in response to several types of stress such as heat (14, 15) and exercise (12). Exercise increased HSP72 expression (2) and attenuated skeletal muscle fiber atrophy (3) in streptozotocin

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Risk Factors for Fractures and Falls in Older Women with Type 2 Diabetes Mellitus

Cited by 77 publications

References 28 publications

Association between the risk of falls and osteoporotic fractures in patients with type 2 diabetes mellitus

Association between the risk of falls and osteoporotic fractures in patients with type 2 diabetes mellitus

Risk factors for recurrent falls among Brazilian women and men: the Brazilian Osteoporosis Study (BRAZOS)

Heat stress attenuates skeletal muscle atrophy of extensor digitorum longus in streptozotocin-induced diabetic rats

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