Hypoglycemia and hyperglycemia are risk factors for falls in the hospital population

  • Cesare BerraEmail author
  • Francesco De Fazio
  • Elena Azzolini
  • Marco Albini
  • Federico Zangrandi
  • Marco Mirani
  • Stefania Garbossa
  • Rodolfo Guardado-Mendoza
  • Gianluigi Condorelli
  • Franco FolliEmail author
Original Article



To determine the role of hypoglycemia, hyperglycemia or the combination of both as independent risk factors for falls in a hospital population. Secondary objectives included evaluation of other risk factors for falling and their relationships with glucose levels.

Research design and methods

Retrospective cohort study over 2 years on hospitalized subjects (N = 57411) analyzing in-hospital-falls and capillary glucose values. Bivariate analysis (χ2 test) and multivariate analysis (logistic regression) were performed to test for correlation of glucose values, age, sex, Charlson index, service of care, diagnosis at discharge and diabetes treatment with risk of in-hospital-falls.


The comparison of patients who experienced a fall (fall population) with the non-fall population suggested that: glucose determinations were significantly more frequent in the fall population (OR 3.45; CI 2.98–3.99; p < 0.0001); values of glucose below 70 mg/dl and over 200 mg/dl were significantly associated to falls during hospitalization (OR 1.76; CI 1.42–2.19; p < 0.001) as compared to glycemic values between 70 and 200 mg/dl; diabetes treatment was significantly correlated to risk of fall (OR 2.97; CI 2.54–3.49; p < 0.001); the frequency of glycemia measurements below 70 mg/dl and over 200 mg/dl in the same subject was significantly associated to falls during hospitalization (OR 1.01; CI 1.01–1.02; p < 0.001).


Hypoglycemia and hyperglycemia during hospital stays are correlated with an increased risk for falls in the hospitalized population. Presence of diabetes, use of insulin or glucose variability could potentially constitute risk factors for falls inside the hospital as well.


Falls Hyperglycemia Hypoglycemia Glucose variability Diabetes In-hospital Insulin Hypoglycemic agents 



Parts of this work have been presented in abstract form at the meetings of IDF 2017 and EASD in 2018.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethical Committee of the Humanitas Research Hospital, Rozzano, Milano, Italy.

Informed consent

All clinical and laboratory informations came from retrospective analysis from non identifiable data, informed consent was not deemed necessary by the Ethical Committee.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2019

Authors and Affiliations

  • Cesare Berra
    • 1
    Email author
  • Francesco De Fazio
    • 2
  • Elena Azzolini
    • 3
  • Marco Albini
    • 2
  • Federico Zangrandi
    • 3
  • Marco Mirani
    • 4
  • Stefania Garbossa
    • 5
    • 6
  • Rodolfo Guardado-Mendoza
    • 7
    • 8
  • Gianluigi Condorelli
    • 9
    • 10
    • 11
  • Franco Folli
    • 5
    • 6
    Email author
  1. 1.Metabolic Disease and DiabetesMultimedica IRCCSMilanItaly
  2. 2.Quality Monitoring OfficeHumanitas Clinical and Research HospitalMilanItaly
  3. 3.Clinical Quality DepartmentHumanitas Clinical and Research HospitalMilanItaly
  4. 4.Metabolic Disease and DiabetesHumanitas Clinical and Research HospitalMilanItaly
  5. 5.Departmental Unit Diabetes and Metabolic DisordersASST Santi Paolo e CarloMilanItaly
  6. 6.Department of Health ScienceUniversity of MilanMilanItaly
  7. 7.Research DepartmentHospital Regional de Alta Especialidad del BajíoLeónMexico
  8. 8.Department of Medicine and NutritionUniversity of GuanajuatoLeónMexico
  9. 9.Department of Cardiovascular MedicineHumanitas Clinical and Research Center - IRCCSMilanItaly
  10. 10.Humanitas UniversityMilanItaly
  11. 11.Institute of Genetics and Biomedical Research (Milan Unit)National Research Council of ItalyMilanItaly

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