Association between visit-to-visit glycated hemoglobin A1c variability and recurrent falls over 12 months in older adults with type 2 diabetes mellitus
- 1Department of Gastroenterology, Chongqing Jiulongpo District People’s Hospital
- 2Department of Endocrinology, Chongqing Wanzhou District Shanghai Hospital
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.
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BibTeX
@article{hu2026association,
title = {{Association between visit-to-visit glycated hemoglobin A1c variability and recurrent falls over 12 months in older adults with type 2 diabetes mellitus}},
author = {Wei Hu and Anjing Shao},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1971401},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1971401/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association between visit-to-visit glycated hemoglobin A1c variability and recurrent falls over 12 months in older adults with type 2 diabetes mellitus
AU - Wei Hu
AU - Anjing Shao
PY - 2026
DA - 2026/10/22
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1971401
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1971401/full
AB - 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.
SN - 1664-2392
ER -