Diabetes mellitus (DM) is associated with an increased risk of fractures in excess of what would be expected from age and BMD. Further, DM is associated with increased risk of mortality in patients with hip fractures and possibly also other osteoporotic fractures.
Study population and methods: Patients aged 50 or over who were treated for fractures of the hip, forearm, humerus and spine over 6 years (20042009, n=146 256) not coded as road traffic accidents were tracked in national registers for 1 year post fracture mortality and for a history of DM by ICD-10 code, with a look-back to 1/1/2000.
Results: Patients with DM sustained their first major osteoporotic fracture at a slightly younger age at the hip only (78.1 vs 80.5, P<0.001). By contrast, forearm (71.8 vs 69.8, P<0.001), and spine fractures (73.2 vs 72.0, P=0.005) occurred at a higher age in patients with DM, with no difference in age for humerus fractures (P=0.34). Patients with DM had poorer 1-year survival after fracture than fracture patients without DM, with the only exception being spine fractures in the very old (age 9099).
Conclusions: The increased risk of fractures in patients with DM does not manifest itself in a clinically significant earlier age a first major osteoporotic fracture. Patients with DM have poorer short term post fracture survival than patients w/o DM irrespective of fracture site.