Uncontrolled blood sugar raises risk of fracture in elderly with Diabetes: Study
Boston, MA: Elevated blood sugar levels, low grip strength, and prior falls are risk factors for fracture in older adults with type 2 diabetes, according to a recent study in the journal Diabetes Care. Evaluation of these factors may reduce the risk of fractures in this high-risk group by improving opportunities for early intervention.
Falls in elderly individuals with diabetes are a significant burden to the healthcare system and a number of factors tied to Diabetes predispose this population to a higher risk of falls.Fractures are one of the most serious fall-related injuries, and diabetes appears to increase the risk for fracture.
Earlier studies have indicated that while risk of a fracture increases with diabetes diagnosis, the good news is with adequate blood sugar control, there is a possibility to decrease this risk, especially in type 1 diabetes.
Alyssa B. Dufour, Harvard Medical School, Boston, MA, and colleagues aimed to identify risk factors for fracture in type 2 diabetes.
For this purpose, the researchers performed a prospective study including members of the Framingham Original and Offspring Cohorts. Type 2 diabetes was defined as fasting plasma glucose >125 mg/dL or the use of type 2 diabetes therapy.
The study included 793 individuals with type 2 diabetes. Mean age was 70 years; 45% were women.
Key findings of the study include:
- A total of 106 incident fractures occurred over 1,437 observation follow-up intervals. Fracture incidence increased with age (adjusted HRs 1.00, 1.44, and 2.40 for <60, 60–70, and >70 years, respectively), female sex (2.23 [1.26, 3.95]), HbA1c (1.00, 2.10 [1.17, 3.75], and 1.29 [0.69, 2.41] for 4.45–6.46% [25–47 mmol/mol], 6.50–7.49% [48–58 mmol/mol], and 7.50–13.86% [58–128 mmol/mol]; Ptrend =0.03), falls in past year (1.00, 1.87 [0.82, 4.28], and 3.29 [1.34, 8.09] for no falls, one fall, and two or more falls), fracture history (2.05 [1.34, 3.12]), and lower grip strength (0.82 [0.69, 0.99] per 5-kg increase).
- Femoral neck bone mineral density, BMI, smoking, physical function, chronic diseases, medications, and physical function were not associated with fracture incidence.
"Prior falls, fractures, low grip strength, and elevated HbA1c are risk factors for fractures in older adults with type 2 diabetes," wrote the authors. "Evaluation of these factors may improve opportunities for early intervention and reduce fractures in this high-risk group."
The study titled, "Risk Factors for Incident Fracture in Older Adults With Type 2 Diabetes: The Framingham Heart Study," is published in the journal Diabetes Care.