Type 2 Diabetes and Risk of Hip Fractures and Non-Skeletal Fall Injuries in the Elderly: A Study From The Fractures And Fall Injuries In The Elderly Cohort (Frailco)

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Wallander, MaritGothenburg University,Göteborgs universitet,Karolinska Institutet,Institutionen för medicin,Centre for Bone and Arthritis Research,Institute of Medicine (author)

Type 2 Diabetes and Risk of Hip Fractures and Non-Skeletal Fall Injuries in the Elderly : A Study From The Fractures And Fall Injuries In The Elderly Cohort (Frailco)

Article/chapterEnglish2017

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2016-10-31
John Wiley & Sons,2017
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:hj-45748
https://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-45748URI
https://doi.org/10.1002/jbmr.3002DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-13011URI
http://kipublications.ki.se/Default.aspx?queryparsed=id:135502729URI
https://gup.ub.gu.se/publication/246292URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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© Copyright 2020
Questions remain about whether the increased risk of fractures in patients with type 2 diabetes (T2DM) is related mainly to increased risk of falling or to bone-specific properties. The primary aim of this study was to investigate the risk of hip fractures and non-skeletal fall injuries in older men and women with and without T2DM. We included 429,313 individuals (aged 80.8 +/- 8.2 years [mean +/- SD], 58% women) from the Swedish registry "Senior Alert" and linked the data to several nationwide registers. We identified 79,159 individuals with T2DM (45% with insulin [T2DM-I], 41% with oral antidiabetics [T2DM-O], and 14% with no antidiabetic treatment [T2DM-none]) and 343,603 individuals without diabetes. During a follow-up of approximately 670,000 person-years, we identified in total 36,132 fractures (15,572 hip fractures) and 20,019 non-skeletal fall injuries. In multivariable Cox regression models where the reference group was patients without diabetes and the outcome was hip fracture, T2DM-I was associated with increased risk (adjusted hazard ratio (HR) [95% CI] 1.24 [1.16-1.32]), T2DM-O with unaffected risk (1.03 [0.97-1.11]), and T2DM-none with reduced risk (0.88 [0.79-0.98]). Both the diagnosis of T2DM-I (1.22 [1.16-1.29]) and T2DM-O (1.12 [1.06-1.18]) but not T2DM-none (1.07 [0.98-1.16]) predicted non-skeletal fall injury. The same pattern was found regarding other fractures (any, upper arm, ankle, and major osteoporotic fracture) but not for wrist fracture. Subset analyses revealed that in men, the risk of hip fracture was only increased in those with T2DM-I, but in women, both the diagnosis of T2DM-O and T2DM-I were related to increased hip fracture risk. In conclusion, the risk of fractures differs substantially among patients with T2DM and an increased risk of hip fracture was primarily found in insulin-treated patients, whereas the risk of non-skeletal fall injury was consistently increased in T2DM with any diabetes medication.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Endokrinologi och diabetes hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Endocrinology and Diabetes hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
General Population Studies
Fracture Risk Assessment
Fracture Prevention
Type 2 Diabetes
Fysisk aktivitet, idrott, hälsa och digital teknik

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Axelsson, Kristian FGothenburg University,Göteborgs universitet,Institutionen för medicin,Centre for Bone and Arthritis Research,Institute of Medicine(Swepub:gu)xaxekr (author)
Nilsson, Anna G,1968Gothenburg University,Göteborgs universitet,Institutionen för medicin,Centre for Bone and Arthritis Research,Institute of Medicine(Swepub:gu)xnannx (author)
Lundh, DanHögskolan i Skövde,Institutionen för biovetenskap,Fysisk aktivitet, IT och hälsa(Swepub:his)lund (author)
Lorentzon, Mattias,1970Gothenburg University,Göteborgs universitet,Institutionen för medicin,Centre for Bone and Arthritis Research,Institute of Medicine(Swepub:gu)xlomat (author)
Karolinska InstitutetInstitutionen för medicin (creator_code:org_t)

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In:Journal of Bone and Mineral Research: John Wiley & Sons32:3, s. 449-4600884-04311523-4681

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