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Diabetes and risk of fracture-related hospitalization: the Atherosclerosis Risk in Communities Study

Andrea L C Schneider1, Emma K Williams, Frederick L Brancati

  • 1Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA.

Diabetes Care
|December 19, 2012
PubMed

Insights

Diabetes increases fracture risk, especially with poor glucose control. This study highlights the need for fracture risk assessment and prevention in individuals with type 2 diabetes.

Area of Science:

  • Epidemiology
  • Metabolic Diseases
  • Gerontology

Background:

  • Diabetes mellitus is a growing global health concern.
  • Fracture risk is a significant complication, particularly in older adults.
  • Glycemic control is a key factor in managing diabetes complications.

Purpose of the Study:

  • To investigate the association between diagnosed and undiagnosed diabetes, glycemic control, and fracture-related hospitalizations.
  • To determine if diabetes independently predicts fracture risk.
  • To assess the impact of insulin treatment and hemoglobin A1c levels on fracture risk.

Main Methods:

  • Analysis of data from the Atherosclerosis Risk in Communities (ARIC) Study.
  • Inclusion of 15,140 participants with a median follow-up of 20 years.
  • Utilizing Cox proportional hazards models to adjust for confounding factors and assess risk.

Main Results:

  • 1,078 incident fracture-related hospitalizations were recorded.
  • Diagnosed diabetes was independently associated with a 74% increased risk of fracture (HR, 1.74).
  • Poor glycemic control (HbA1c ≥8%) and insulin treatment further elevated fracture risk in diabetic individuals.

Conclusions:

  • The findings support proactive fracture risk assessment in individuals with type 2 diabetes.
  • Recommendations for implementing fracture prevention strategies are warranted, particularly for those with suboptimal glucose control.
  • This research underscores the importance of comprehensive diabetes management beyond glycemic targets.
Abstract

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