Type 1 Puts Your Type 1 Patients at Risk for Fractures

From the Spring Research Guide

| Apr 1, 2006

Having diabetes, especially type 1, puts you at an increased risk for all non-vertebral fractures—in particular, hip fractures.

This was the opinion of Norwegian researchers who, over the course of six years, studied 27,159 participants. All non-vertebral fractures were registered by computerized search in radiographic archives.

“A total of 1,249 non-vertebral fractures was registered, and 455 validated cases of diabetes were identified,” write the researchers. “Men with type 1 diabetes had an increased risk of all non-vertebral and hip fractures. Diabetic women, regardless of type of diabetes, had significantly increased hip fracture risk for type 1 and type 2 diabetes, respectively.”

They add that diabetic men and women using insulin had increased hip fracture risk. Duration of having diabetes did not alter hip fracture risk.

Osteoporosis International, November 2005

Luai A. Ahmed was a lead researcher on this study:

Can you speculate on why there is a high incidence of non-vertabral fractures in these patient populations?

The higher incidence of non-vertebral fractures among patients with diabetes could be related to the effect of the disease and/or its medications, complications or co-morbidities on the bone mass/structure and the tendency to fall. Reduced bone mass or altered bone structure result in a fragile bone. Type I diabetes is usually associated with low bone mass due to high rates of bone turnover and resorption, while type 2 diabetes mellitus might cause a structurally altered bone.

What measures can be taken to remedy or prevent these types of fractures?

It is important to be aware of the increased fracture risk among subjects with diabetes. Good control of the disease, appropriate nutrition and lifestyle interventions are important measures to preserve bones and prevent fractures. Home hazard assessment, muscle strengthening, balance training, withdrawal of psychotropic medications and the use of hip protectors should be considered, especially in those with other chronic disease(s)—such as retinopathy or neuropathy—to prevent additional increase in the risk of fracture in these patients. Patients with low bone mass or a fracture should be considered for pharmaceutical interventions.

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Apr 1, 2006

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