TORONTO — The risk for hip fractures appears to be elevated in elderly men and women with diabetes, Dr. Lorraine L. Lipscome reported in a poster at the joint annual meeting of the Canadian Diabetes Association and the Canadian Society of Endocrinology and Metabolism.
In a retrospective cohort study using population-based Ontario health care databases from 1994 to 2003, researchers compared the risk of hip fractures between individuals older than 65 years of age with and without diabetes. The study population comprised 207,252 diabetics and 414,504 nondiabetics, with a mean age of 71.7 years for the entire group, said Dr. Lipscome, of the University of Toronto.
After a mean of 6.1 years, the risk for hip fractures was significantly higher in those with diabetes, at 7.21 per 1,000 person-years, compared with 6.15 per 1,000 person-years among those without diabetes.
Those with diabetes had more comorbidity, were less likely to have had a bone mineral density test, and were more likely to be taking drugs that affected fall risk and bone density.
Women had a significantly higher risk for fracture than did men, but diabetes increased the risk in both genders, with hazard ratios of 1.22 for men and 1.19 for women. The increased risk remained significant (1.18 in men and 1.11 in women) after adjustment for age, comorbidity, and other factors, Dr. Lipscome reported.
Insulin use among the patients with diabetes increased the fracture risk, with hazard ratios of 1.34 in women and 1.64 in men compared with those not using insulin.
Until the phenomenon is better understood, bone fracture risk assessment and enhanced prevention strategies are warranted in all patients with diabetes, she said.