Adults diagnosed with diabetes are at significantly increased risk for
fracture-related hospitalization, says a Medscape
Medical News article
based on the results from an analysis of data from a large, community-based
More than 15,100 patients between 45 and 64 years old participated in the
Atherosclerosis Risk in Communities (ARIC) study, a 4-community study that
began in 1987. There were a total of 1,078 fracture-related hospitalizations
during the 20-year follow-up period. (Only fractures that resulted in inpatient
hospitalization were captured in ARIC.)
At baseline, 1,195 participants had been diagnosed with diabetes based on
self-report, and 605 had undiagnosed diabetes according to their measured serum
Compared with the 13,340 study participants without diabetes, the incidence
of fracture-related hospitalization was significantly greater among the group
with diagnosed diabetes (6.6 vs 3.9 per 1,000 person-years of follow-up).
The incidence of fracture hospitalization was higher among those with
diagnosed diabetes compared with those without diabetes for all age groups.
However, the fracture risk was not increased among those with undiagnosed
diabetes compared with those without diabetes, the article says.
After adjustment for the covariates, diagnosed diabetes still was associated
with a significantly increased risk for fracture hospitalization, with a hazard
ratio (HR) of 1.74.
However, also in the fully adjusted analysis, the fracture risk among those
with undiagnosed diabetes was similar to that for those participants without
diabetes (HR 1.12).
There also was a significant relationship with glycemic control. After
adjustment, participants with diagnosed diabetes who had hemoglobin A1c values
of 8% or greater had a significantly greater risk for fracture hospitalization
than did those with A1c values less than 8% (HR 1.63). After further
adjustment for diabetes medication use that risk was reduced (HR 1.50).
The authors say further studies are needed to understand if exercise
interventions or strategies to improve glycemic control while minimizing
hypoglycemic episodes may prevent fractures among people with diabetes.
The study was published online December 17 in Diabetes Care.