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Association between glycemic control and hip fracture
Troy H Puar1, Joan J Khoo, Li W Cho
1Department of Endocrinology, Changi General Hospital, Singapore, Singapore. Troy_Puar@yahoo.com
Journal of the American Geriatrics Society
|August 7, 2012
Summary
Tight glycemic control (HbA1c < 7%) in type 2 diabetes patients is linked to a higher risk of hip fractures. This finding suggests careful management is needed for older adults with diabetes to prevent bone injuries.
Area of Science:
- Endocrinology
- Geriatrics
- Orthopedics
Background:
- Type 2 diabetes mellitus is a prevalent condition associated with various complications.
- Glycemic control is a cornerstone of diabetes management, but its impact on fracture risk is debated.
- Hip fractures pose a significant health burden, particularly in older populations.
Purpose of the Study:
- To investigate the association between glycemic control, measured by HbA1c levels, and the risk of hip fractures in individuals with type 2 diabetes.
- To determine if tighter glycemic control correlates with an increased likelihood of hip fractures.
Main Methods:
- A case-control study was conducted at a tertiary hospital.
- Cases comprised individuals with diabetes admitted for hip fracture (N=932), matched with controls based on sex, age, race, diabetes duration, and comorbidities.
- Glycosylated hemoglobin (HbA1c) levels, measured within three months of fracture, were compared across different glycemic control categories (<6%, 6.1-7.0%, 7.1-8.0%, >8%).
Main Results:
- Individuals with tighter glycemic control (HbA1c < 6% and 6.1-7.0%) had a significantly higher odds of hip fracture compared to the reference group (HbA1c >8%).
- Adjusted odds ratios for hip fracture were 3.01 (95% CI: 2.01-4.51) for HbA1c < 6% and 2.34 (95% CI: 1.71-3.22) for HbA1c 6.1-7.0%.
- No significant difference in the use of insulin or sulfonylurea was observed between cases and controls.
Conclusions:
- Tight glycemic control (HbA1c < 7%) is associated with an increased risk of hip fractures in patients with type 2 diabetes mellitus.
- Healthcare providers should exercise increased caution when managing glycemic control in older diabetic patients to mitigate fracture risk.
- Further research may be warranted to elucidate the mechanisms underlying this association.
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