Type 1 Puts Your Type 1 Patients at Risk for Fractures

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

This was the opinion of Norwegianresearchers who, over the course ofsix years, studied 27,159 participants. All non-vertebral fractures wereregistered by computerized search inradiographic archives.

“A total of 1,249 non-vertebralfractures was registered,and 455 validated cases ofdiabetes were identified,”write the researchers.“Men with type 1 diabeteshad an increased riskof all non-vertebral andhip fractures. Diabetic women,regardless of type of diabetes, hadsignificantly increased hip fracturerisk for type 1 and type 2 diabetes,respectively.”

They add that diabetic men andwomen using insulin had increasedhip fracture risk. Duration of havingdiabetes did not alter hip fracture risk.

Osteoporosis International,November 2005

Luai A. Ahmed was a lead researcher onthis study:

Can you speculate on why there is a highincidence of non-vertabral fractures in thesepatient populations?

The higher incidence of non-vertebral fractures amongpatients with diabetes could be related to the effect ofthe disease and/or its medications, complications or co-morbiditieson the bone mass/structure and the tendencyto fall. Reduced bone mass or altered bone structure resultin a fragile bone. Type I diabetes is usually associated withlow bone mass due to high rates of bone turnover andresorption, while type 2 diabetes mellitus might cause astructurally altered bone.

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

It is important to be aware of the increased fracture riskamong subjects with diabetes. Good control of the disease,appropriate nutrition and lifestyle interventions areimportant measures to preserve bones and prevent fractures.Home hazard assessment, muscle strengthening, balancetraining, withdrawal of psychotropic medications and theuse of hip protectors should be considered, especially inthose with other chronic disease(s)—such as retinopathyor neuropathy—to prevent additional increase in the riskof fracture in these patients. Patients with low bone massor a fracture should be considered for pharmaceuticalinterventions.

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