Calcaneal Ultrasound Shows Promise in Fracture Risk Assessment for Type 2 Diabetes Patients: Study

A recent study published in Clinical Endocrinology explores the usefulness of calcaneal quantitative ultrasound (QUS) as a tool for long-term fracture risk assessment in individuals with diabetic osteopathy, particularly those with type 2 diabetes mellitus (T2DM). While traditional methods like bone densitometry and commonly used fracture risk algorithms often lack reliability in diabetic patients, QUS offers a promising, non-invasive and low-cost alternative that has already proven effective in primary osteoporosis.

The study aimed to determine whether calcaneal QUS could provide accurate estimates of fragility fracture risk over a decade. Researchers reviewed records from 300 patients with either type 1 (T1DM) or type 2 diabetes who underwent calcaneal QUS testing in 2013. This evaluation included measurements of broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI), along with patient histories of clinical fragility fractures and diabetes-related characteristics.

Ten years later, patients were contacted for a follow-up interview to report any new clinical fragility fractures experienced between 2013 and 2023. The study found that patients who had fractures-both at the beginning and during the follow-up period-tended to have lower QUS values. In particular, BUA was found to be associated with the development of major osteoporotic fractures over ten years in patients with type 2 diabetes, reinforcing its potential role in long-term fracture risk prediction.

This association was not observed in patients with type 1 diabetes.

Overall, the findings suggest that calcaneal QUS could serve as an effective tool for evaluating fracture risk in individuals with type 2 diabetes, providing a valuable addition to current clinical practices where traditional assessment methods may fall short.