NEW STUDY reveals an increased risk of subsequent fractures in patients with diabetes who had already experienced an initial hip fracture (HF). The study collected data from Danish medical databases and examined the incidence rates of subsequent hip fractures and other fractures within two years of the first incident, comparing patients with and without diabetes.
The study collected data on 92,600 patients who experienced an initial hip fracture between 2004 and 2018. Among those, 12% of patients had diabetes and 89% had Type 2 diabetes (T2D) and 11% had Type 1 diabetes (T1D). The researchers estimated the cumulative incidence of subsequent hip fractures and other fractures within two years of the initial hip fracture.
Results showed that patients without diabetes had a 2-year incidence rate of 4.8% for new hip fracture. While patients with T2D had a slightly lower incidence rate of 4.1%, and those with T1D had an incidence rate of 4.3%. The adjusted hazard ratios for subsequent hip fractures were 1.01 for T2D and 1.17 for T1D, indicating no significant overall increased risk. However, the risk was notably higher in women with T1D (aHR 1.52) and in patients with specific diabetes complications such as hypoglycaemia (aHR 1.75 for T2D) and neuropathy (aHR 1.73 for T1D).
Additionally, patients without diabetes had a 2-year incidence rate of 7.3% for other types of fractures. Patients with T2D had an incidence rate of 6.6%, while those with T1D had a higher incidence rate of 8.5%. The adjusted hazard ratios for other fractures were 1.01 for T2D and 1.43 for T1D. T2D showed to be a risk factor for other types of fractures only in older patients. While T1D was consistently associated with an increased risk of other fractures among all subgroups.
The study found no significant overall association between diabetes and the increased risk of subsequent hip fractures. However, patients with diabetes who had prior hypoglycaemic events or neuropathy were at an increased risk. In contrast, patients with T1D exhibited a clearly increased risk of fractures other than hip fractures. These findings highlight the importance of implementing preventative strategies for fracture risk in diabetic patients, especially those with additional complications and those of advanced age.
Reference
Vinther D et al. Impact of diabetes on the risk of subsequent fractures in 92,600 patients with an incident hip fracture: A Danish nationwide cohort study 2004–2018. Bone. 2024;184:117104.
