Fractures in type 2 diabetes poses excess mortality risk

For type 2 diabetes patients (T2D), the presence of any fracture contributes to a significant increase in the risk of mortality, a study has found.

The study used data from the Dubbo Osteoporosis Epidemiology Study and included 3,618 adults (62 percent female). The main outcome was all-cause mortality, while first incident radiological fragility fracture and incident T2D diagnosis were time-dependent variables.

Of the participants, 272 had T2D at baseline while 179 developed T2D over a median follow-up of 13.0 years (interquartile range, 8.2–19.6). Meanwhile, fractures occurred in 796 women (56 with T2D) and 240 men (25 with T2D).

Relative to participants with neither T2D nor fracture, mortality risk increased progressively in the group with T2D but no fracture, the group with no T2D but with fracture, and was highest in the group with both T2D and fracture (women: adjusted hazard ratio [aHR], 2.62, 95 percent confidence interval [CI], 1.75–3.93; men: aHR, 2.61, 95 percent CI, 1.42–4.81).

Within the T2D groups, incident fracture was associated with greater mortality risk (women: aHR, 1.87, 95 percent CI, 1.10–3.16; men: aHR, 2.83, 95 percent CI, 1.41–5.68). The risk increase was especially pronounced among men with hip/vertebral fractures (aHR, 2.97, 95 percent CI, 1.29–6.83) and among women with nonhip/nonvertebral fractures (aHR, 2.42, 95 percent CI, 1.24–4.75), and in the group with T2D duration >5 years.

The findings underscore the importance of close monitoring of T2D patients who sustained fracture, especially those whose T2D duration is >5 years. Enhancing fracture prevention and postfracture management in T2D is critical and warrants further investigation.