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Title:
Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk | Diabetologia
Description:
Aims/hypothesis We studied the association between fractures and type 1 and type 2 diabetes mellitus. Methods In this case-control study, all subjects diagnosed with a fracture (n=124,655) in Denmark served as cases, and for each case three control subjects (n=373,962) matched for sex and age were retrieved from the general population. Results Type 1 and type 2 diabetes were associated with an increased risk (1) of any fracture (odds ratio [OR]=1.3, 95% CI: 1.2โ1.5 for type 1 diabetes and 1.2, 95% CI: 1.1โ1.3 for type 2 diabetes after adjustment for confounders) and (2) of hip fractures (OR=1.7, 95% CI: 1.3โ2.2 for type 1 diabetes, and 1.4, 95% CI: 1.2โ1.6 for type 2 diabetes). Furthermore, type 2 diabetes was associated with a significant increase in forearm fractures (OR=1.2, 95% CI: 1.0โ1.5), and type 1 diabetes was associated with an increased risk of spine fractures (OR=2.5, 95% CI: 1.3โ4.6), whereas type 2 diabetes was not. Use of metformin and sulphonylureas was associated with a significantly decreased risk of any fracture, whereas a non-significant trend towards decreased risk of any fracture was associated with the use of insulin. Except for a decrease in hip fractures with use of sulphonylureas, no change in fracture risk in the hip, spine or forearm was associated with the use of insulin or oral antidiabetic drugs. Conclusions/interpretation Type 1 and type 2 diabetes are associated with an increased risk of any fracture and hip fractures. The use of drugs to control diabetes may reduce the association between diabetes and fractures.
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Keywords {๐}
diabetes, type, fracture, risk, fractures, google, scholar, pubmed, study, bone, patients, cas, control, article, drugs, increased, subjects, insulin, mellitus, antidiabetic, hip, denmark, bmd, mineral, cases, forearm, relative, year, number, table, information, decreased, women, density, casecontrol, increase, register, exposure, danish, types, date, data, oral, population, spine, sulphonylureas, studies, metabolism, reported, national,
Topics {โ๏ธ}
dual x-ray absorptiometry registry-based case-control design melton lj iii hospital-based discharge registry nordโtrondelag health survey conditional logistic regression statin cholesterol-lowering drugs johnston cc jr nation-wide register study insulin-dependent diabetes mellitus insulin-dependent diabetes mellitus negative calcium balance privacy choices/manage cookies matched case-control studies anatomical therapeutical chemical insulin-treated diabetes mellitus poor metabolic control psychiatric central register bone mineral density sex-matched control subjects cholesterol-lowering drugs defined daily doses tableย 3 relative risk tableย 4 relative risk bone mineral acquisition avoid ascertainment bias danish medicines agency nation-wide follow norton ja jr lowest daily doses approximate relative risks control group presumed clin res ed bone mineral loss european economic area power calculations showing lopez-ibarra pj schwartz av case-control design significantly decreased risk tableย 4 shows parathyroid hormone metabolism register-based study term โcaseโ denotes initial poor control spontaneously diabetic rats specific skeletal sites compromise blood supply article vestergaard search search
Questions {โ}
- Dennison EM, Syddall HE, Aihie SA, Craighead S, Phillips DI, Cooper C (2004) Type 2 diabetes mellitus is associated with increased axial bone density in men and women from the Hertfordshire Cohort Study: evidence for an indirect effect of insulin resistance?
- Jones G, Nguyen T, Sambrook PN, Eisman JA (1995) Thiazide diuretics and fractures: can meta-analysis help?
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headline:Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk
description:We studied the association between fractures and type 1 and type 2 diabetes mellitus. In this case-control study, all subjects diagnosed with a fracture (n=124,655) in Denmark served as cases, and for each case three control subjects (n=373,962) matched for sex and age were retrieved from the general population. Type 1 and type 2 diabetes were associated with an increased risk (1) of any fracture (odds ratio [OR]=1.3, 95% CI: 1.2โ1.5 for type 1 diabetes and 1.2, 95% CI: 1.1โ1.3 for type 2 diabetes after adjustment for confounders) and (2) of hip fractures (OR=1.7, 95% CI: 1.3โ2.2 for type 1 diabetes, and 1.4, 95% CI: 1.2โ1.6 for type 2 diabetes). Furthermore, type 2 diabetes was associated with a significant increase in forearm fractures (OR=1.2, 95% CI: 1.0โ1.5), and type 1 diabetes was associated with an increased risk of spine fractures (OR=2.5, 95% CI: 1.3โ4.6), whereas type 2 diabetes was not. Use of metformin and sulphonylureas was associated with a significantly decreased risk of any fracture, whereas a non-significant trend towards decreased risk of any fracture was associated with the use of insulin. Except for a decrease in hip fractures with use of sulphonylureas, no change in fracture risk in the hip, spine or forearm was associated with the use of insulin or oral antidiabetic drugs. Type 1 and type 2 diabetes are associated with an increased risk of any fracture and hip fractures. The use of drugs to control diabetes may reduce the association between diabetes and fractures.
datePublished:2005-05-21T00:00:00Z
dateModified:2005-05-21T00:00:00Z
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Diabetes
Epidemiology
Fracture
Insulin
Metformin
Risk
Sulphonylurea
Internal Medicine
Metabolic Diseases
Human Physiology
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headline:Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk
description:We studied the association between fractures and type 1 and type 2 diabetes mellitus. In this case-control study, all subjects diagnosed with a fracture (n=124,655) in Denmark served as cases, and for each case three control subjects (n=373,962) matched for sex and age were retrieved from the general population. Type 1 and type 2 diabetes were associated with an increased risk (1) of any fracture (odds ratio [OR]=1.3, 95% CI: 1.2โ1.5 for type 1 diabetes and 1.2, 95% CI: 1.1โ1.3 for type 2 diabetes after adjustment for confounders) and (2) of hip fractures (OR=1.7, 95% CI: 1.3โ2.2 for type 1 diabetes, and 1.4, 95% CI: 1.2โ1.6 for type 2 diabetes). Furthermore, type 2 diabetes was associated with a significant increase in forearm fractures (OR=1.2, 95% CI: 1.0โ1.5), and type 1 diabetes was associated with an increased risk of spine fractures (OR=2.5, 95% CI: 1.3โ4.6), whereas type 2 diabetes was not. Use of metformin and sulphonylureas was associated with a significantly decreased risk of any fracture, whereas a non-significant trend towards decreased risk of any fracture was associated with the use of insulin. Except for a decrease in hip fractures with use of sulphonylureas, no change in fracture risk in the hip, spine or forearm was associated with the use of insulin or oral antidiabetic drugs. Type 1 and type 2 diabetes are associated with an increased risk of any fracture and hip fractures. The use of drugs to control diabetes may reduce the association between diabetes and fractures.
datePublished:2005-05-21T00:00:00Z
dateModified:2005-05-21T00:00:00Z
pageStart:1292
pageEnd:1299
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keywords:
Diabetes
Epidemiology
Fracture
Insulin
Metformin
Risk
Sulphonylurea
Internal Medicine
Metabolic Diseases
Human Physiology
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