Magazine article Clinical Psychiatry News

Diabetes and Bone Fracture Risk: Disease Duration Appears Critical

Magazine article Clinical Psychiatry News

Diabetes and Bone Fracture Risk: Disease Duration Appears Critical

Article excerpt

PHILADELPHIA -- Newly diagnosed diabetes appears to confer a protective effect against fracture that disappears with increased disease duration, ultimately leading to an increased fracture risk in patients with long-term disease, according to data presented at the annual meeting of the American Society for Bone and Mineral Research.

Patients with newly diagnosed diabetes had an 11% lower risk of osteoporotic fracture and an 18% lower risk of hip fracture, compared with controls, in a retrospective study of 82,094 diabetic patients and 236,682 control subjects. Individuals who have had diabetes for less than 5 years had the same risk as did controls for an osteoporotic fracture. People with diabetes of longer duration had a significantly greater risk of osteoporotic fractures in general (9% greater) and hip fractures in particular (36% greater).

The study's findings provide "compelling evidence that long-term diabetes is associated with increased fracture risk and that newly diagnosed diabetes shows some protective effect," said Dr. William D. Leslie, a professor of endocrinology and metabolism at the University of Manitoba, Winnipeg.

Several population-based studies have shown that bone density is increased in patients with type 2 diabetes. "Paradoxically, fracture risk [in diabetic patients] is much greater than can be explained on the basis of bone density," Dr. Leslie said. Diabetic complications leading to falls and possibly altered bone quality are thought to mediate these effects, but the exact relationship between diabetes and fracture risk has not been determined.

For this study, the researchers used fracture data from the Population Health Information System for the Province of Manitoba from 1984 to 2004. Each diabetic adult in the database who was at least 20 years old (as of Jan. 1, 1994) was matched with three nondiabetic control subjects based on gender, birth year, area of residence, and aboriginal or nonaboriginal ethnicity. …

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