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Association between visit-to-visit glycated hemoglobin A1c variability and recurrent falls over 12 months in older adults with type 2 diabetes mellitus

Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Visit-to-visit glycated hemoglobin A1c (HbA1c) variability may capture glycemic instability beyond mean HbA1c, but its association with recurrent falls in older adults remains uncertain. Methods This single-center retrospective cohort study included 286 adults aged ≥65 years with type 2 diabetes who received outpatient follow-up at Chongqing Jiulongpo District People’s Hospital and had at least four HbA1c measurements during a 365-day exposure window. Recurrent falls were defined as at least two independent falls during the subsequent 365 days. Modified Poisson regression with robust variance estimated risk ratios (RRs) for the HbA1c coefficient of variation (HbA1c-CV); negative binomial regression assessed fall counts. Results Recurrent falls occurred in 77 participants (26.9%). The median HbA1c-CV was 7.0%, and its between-patient sample standard deviation (SD) was 3.1 percentage points. Each 1-SD increase in HbA1c-CV was associated with recurrent falls after adjustment (RR, 1.34; 95% confidence interval [CI], 1.16–1.55; P < 0.001). Compared with the lowest tertile, the highest tertile had an adjusted RR of 2.03 (95% CI, 1.19–3.47; P = 0.010). Restricted cubic spline analysis showed no evidence of nonlinearity ( P = 0.294). Higher HbA1c-CV was also associated with a higher fall incidence rate (adjusted incidence rate ratio per 1-SD increase, 1.37; 95% CI, 1.18–1.58; P < 0.001). Conclusion Greater visit-to-visit HbA1c variability was associated with recurrent falls and a higher fall burden in older adults with type 2 diabetes. HbA1c-CV may complement multidimensional fall-risk assessment.
DOI: 10.3389/fendo.2026.1971401
Language: English
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223171699
FWCI:
Cites: 36
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Related to: 10