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Postfracture survival rate worse in adults with diabetes
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Adults with diabetes have a poorer 1-year survival rate after fracture, despite research showing they sustain their first fractures at most sites at nearly the same age as those without diabetes, according to recent study findings presented at the Society for Endocrinology Annual Conference.
“To our surprise, the increased risk of fractures in patients with [diabetes] did not manifest itself in a clinically significant earlier age at the first major osteoporotic fracture,” Bo Abrahamsen, MD, PhD, a professor and consultant endocrinologist at the Institute of Clinical Research, SDU, and Holbæk Hospital, Denmark, told Endocrine Today. “We also confirmed that postfracture survival is poorer in patients with diabetes after all types of osteoporotic fractures with a few exceptions, such as male hip fractures and fractures in patients in their 90s.”
Bo Abrahamsen
Abrahamsen and colleagues analyzed national hospital data from 146,256 adults aged at least 50 years treated for fractures of the hip, forearm, humerus and spine between 2004 and 2009. Those with injuries coded as road traffic accidents were excluded. Researchers analyzed 1-year postfracture mortality and history of diabetes in the cohort going back to January 2000 and found that patients with diabetes sustained their first major osteoporotic fracture at a slightly younger age for hip fractures (78.1 years vs. 80.5 years; P < .001), whereas forearm and spine fractures occurred at a slightly older age in those with diabetes (71.8 and 73.2 years vs. 69.8 and 72 years, respectively). There was no age difference for humerus fractures.
Researchers also found that 1-year survival was worse for patients with diabetes than those without after sustaining a fracture, with the exception of spine fractures among adults aged at least 90 years.
Abrahamsen noted that researchers could not reliably differentiate between type 1 and type 2 diabetes in the National Patient Discharge Register and that milder cases of diabetes treated exclusively in the primary care setting were not included.
“It is good news that patients with diabetes do not suffer their first osteoporotic fracture at an earlier age than others because it means that patients with diabetes can expect to remain free of osteoporotic fractures for as long a time as persons who do not have diabetes,” Abrahamsen told Endocrine Today. “However, older patients will still experience more osteoporotic fractures if they have diabetes, so it is important to recognize diabetes as an important risk factor for fractures. Patients with diabetes also warrant particular clinical attention in the fracture wards and [fracture liaison services] due to their increased risk of mortality.” – by Regina Schaffer
Reference:
Abrahamsen B, et al. Abstract #0043. Presented at: Society for Endocrinology Annual Conference; Nov. 2-4, 2015; Edinburgh, Scotland
Disclosure: Abrahamsen reports institutional research contracts with Novartis for pharmacovigilance studies.