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Association between haemoglobin A1c level and hip fracture risk in type 2 diabetes patients: A systematic review and
Mohammad Arshad Ikram1, Justin Vijay Gnanou2, Chin Chai Chong1
1Department of Orthopaedics, International Medical University, Clinical Campus Seremban, Seremban, Negeri Sembilan, 70300, Malaysia.
Background:
Hip fractures are prevalent in the elderly. Diabetes complication includes osteoporosis, which raises the possibility of hip fractures in an elderly population with type 2 diabetes mellitus. The purpose of this Meta-analysis is to determine whether long-term glycaemic management, as measured by HbA1c in patients with diabetes mellitus, is associated with a lower incidence of hip fractures.
Methods:
The study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 (PRISMA) guidelines. We searched PubMed, Ovid, and ScienceDirect, and did a manual search of the reference lists of identified studies for published data on the association between hip fractures and glycaemic control. This systematic review was registered with PROSPERO with a Registration number: CRD42021260328. All eligible articles were included, and a meta-analysis on the comparison between HbA1c values above 6.5 and below 6.5 and between HbA1c values above 6.0 and below 6.0 in patients above 65 years with diabetes mellitus will be done by using a Forest plot. Odds Ratio (OR) and 95 % confidence intervals (CIs) will be calculated as summary statistics for dichotomous outcomes.
Results:
Thirty-seven relevant articles were identified in the initial search, and four of these studies met the inclusion criteria for this systematic review and meta-analysis.
Conclusion:
Our study suggests that hip fractures are more common in the elderly diabetic population when haemoglobin A1c levels exceed 6.5 %.
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