Older women with diabetes have an increased risk of fracture: A prospective study

To determine whether type 2 diabetes is associated with fracture in older w omen, we analyzed data from 9654 women, age 65 yr or older, in the Study of Osteoporotic Fractures. Diabetes with age at onset 40 yr or older was repo rted by 657 women, of whom 106 used insulin. A total of 2624 women experien ced at least one nonvertebral fracture during an average follow-up of 9.4 y r, and 388 had at least one vertebral fracture during an average interval o f 3.7 yr. Although diabetes was associated with higher bone mineral density, it was a lso associated with a higher risk of specific fractures. Compared with nond iabetics, women with diabetes who were not using insulin had an increased r isk of hip [relative risk (RR), 1.82; 95% confidence interval (CI), 1.24-2. 69] and proximal humerus (RR, 1.94; 95% CI, 1.24-3.02) fractures in multiva riate models controlling for age, body mass index, bone density, and other factors associated with fractures and diabetes. Insulin-treated diabetics h ad more than double the risk of foot (multivariate adjusted RR, 2.66; 95% C I, 1.18-6.02) fractures compared with nondiabetics. This study indicates that diabetes is a risk factor for hip, proximal humer us, and foot fractures among older women, suggesting that fracture preventi on efforts should be a consideration in the treatment of diabetes.