Endocrine Abstracts (2011) 26 P705

Diabetes mellitus and risk of fracture

A A Gusova1, M G Pavlova1, G A Melnichenko1, G M Kavalersky1, L L Silin1 & Yu I Sountsov1,2

1I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation; 2FSE Research Centre of Endocrinology, Moscow, Russian Federation.

Objective: To examine association between diabetes properties (type, duration, treatment regiment etc.) and risk of any fracture in diabetic population.

Methods: We analyzed local trauma clinic data for 3 sequential years from 2662 diabetic persons who were entered The National Register of diabetes mellitus patients (133 subjects with type 1 diabetes mellitus (T1DM) and 1995 ones with T2DM).

Results: Fracture risk was higher in T1DM people compared to T2DM ones (relative risk 1.67; 95% CI 1.22–3.40). In T1DM subjects, fractures of foot and hand were more frequent (P=0.028). We haven’t found in T2DM population any significant influence on fracture risk of gender, age, body mass index, diabetes duration and use of any antidiabetic drugs. Presence of diabetic retinopathy, nephropathy or macroangiopathy (atherosclerosis of coronal, cerebral and/or lower limb arteries) was associated with two-fold higher risk of all fractures while diabetic neuropathy was not (RR 1.77; 95% CI 0.96–3.25). Among 149 T2DM patients who were interviewed via telephone, fracture risk was increased in current smokers (RR 3.1, 95% CI 1.08–8.88) and daily coffee drinkers (>7 cups a week) compared with rarely drinkers (<1 cup a week: RR 10.9; 95% CI 1.18–101.13). Elevation of risk was also observed for women with short period of lactation (1–5 months: RR 3.06; 95% CI 1.02–9.16). The risk was decreasing along either with prolongation of breastfeeding and for women with two or more children whereas this reduction wasn’t statistically significant.

Conclusion: These results indicate that main fracture risk factors in diabetic population are diabetic complications, suggesting that fracture prevention strategy should be a consideration in the treatment of diabetes. Influence of lifestyle factors are also significant and should be took into account for vulnerable group definition.

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