Glucose Control, Sulfonylureas, and Insulin Treatment in Older Adults With Type 2 Diabetes and Risk of Falls and Fractures: An Observational Study
Main finding · Hospitalization for fallsResult — go to the resultHazard ratio 1.04 95% CI 0.96–1.11Authors' conclusion
We found no evidence of an association between sustained HbA1c <7% while receiving insulin or sulfonylurea therapy and clinically meaningful increased risks of falls or fractures in older adults with T2D. Clinicians should continue to balance the benefits of glycemic control with the risks of complications in older adults.
Study context
- Population
- Older adults (≥70 years) with T2D, identified 2000–2017, UKmatched cohort
- Participants
- 21,365 adults
- Exposure
- Sustained HbA1c <7% on insulin or SU vs nonexposed
- Exposedn = 5,833
- Outcome
- Hospitalizations for falls and fractures
Methodological detailsobservational, UK Clinical Practice Research Datalink GOLD linked to hospital and death records, 1:3 matching, flexible parametric survival models, adjusted
- Observational
- UK Clinical Practice Research Datalink GOLD linked to hospital and death records
- 1:3 matching
- Flexible parametric survival models, adjusted
Main finding
Hospitalization for falls
Hazard ratio
1.04
95% CI 0.96–1.11
Exposedvs Nonexposed
HR 1.04 (95% CI 0.96–1.11)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Hospitalization for fracturesAdjusted | 1.07 (0.97–1.17) | |
| 0.512Hazard ratio (log scale) |
| Outcome | Exposed | Nonexposed |
|---|---|---|
| 10-year absolute risk of hospitalization for falls (aged 70-85 years)Values are ranges | 15.6-36.8% | 15.1-36.0% |
- 10-year absolute risk of hospitalization for falls (aged 70-85 years) — Absolute risk differences at 5 years
- 0.2-0.6%
- 10-year absolute risk of hospitalization for falls (aged 70-85 years) — Absolute risk differences at 10 years
- 0.5-0.8%
Original publication
Glucose Control, Sulfonylureas, and Insulin Treatment in Older Adults With Type 2 Diabetes and Risk of Falls and Fractures: An Observational Study. Diabetes Care. Published 18 June 2025. doi:10.
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