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Incident Type 2 Diabetes and Risk of Fracture: A Comparative Cohort Analysis Using U.K. Primary Care Records

Davie, Gabrielle S.; Pal, Kingshuk; Orton, Elizabeth; Tyrrell, Edward G.; Petersen, Irene

Incident Type 2 Diabetes and Risk of Fracture: A Comparative Cohort Analysis Using U.K. Primary Care Records Thumbnail


Authors

Gabrielle S. Davie

Kingshuk Pal

Irene Petersen



Abstract

Objective: To estimate risk of fracture in men and women with recent diagnosis of type 2 diabetes compared to individuals without diabetes.

Research Design and Methods: In this cohort study we used routinely-collected UK primary care data from The Health Improvement Network. In adults (>35 years) diagnosed with type 2 diabetes between 2004-2013 fractures sustained until 2019 were identified and compared to fractures sustained in individuals without diabetes. Multivariable models estimated time to first fracture following diagnosis of diabetes. Annual prevalence rates included at least one fracture in a given year.

Results: Among 174,244 individuals with incident type 2 diabetes and 747,290 without diabetes, there was no increased risk of fracture among males with diabetes (adjusted hazards ratio (aHR) 0.97 (95%CI 0.94, 1.00)) and a small reduced risk among females (aHR 0.94, (95%CI 0.92, 0.96)). In those aged 85 years and over those in the diabetes cohort were at significantly lower risk of incident fracture (Males: aHR 0.85, 95%CI 0.71, 1.00; Females: aHR 0.85, 95%CI 0.78, 0.94). For those in the most deprived areas, aHRs were 0.90 (95%CI 0.83, 0.98) for males and 0.91 (95%CI 0.85, 0.97) for females. Annual fracture prevalence rates, by sex, were similar for those with and without type 2 diabetes.

Conclusion: We found no evidence to suggest a higher risk of fracture following diagnosis of type 2 diabetes. After a diagnosis of type 2 diabetes individuals should be encouraged to make positive lifestyle changes, including undertaking weight-bearing physical activities that improve bone health.

Citation

Davie, G. S., Pal, K., Orton, E., Tyrrell, E. G., & Petersen, I. (2021). Incident Type 2 Diabetes and Risk of Fracture: A Comparative Cohort Analysis Using U.K. Primary Care Records. Diabetes Care, 44(1), 58-66. https://doi.org/10.2337/dc20-1220

Journal Article Type Article
Acceptance Date Sep 30, 2020
Online Publication Date Nov 4, 2020
Publication Date Jan 1, 2021
Deposit Date Nov 26, 2020
Publicly Available Date Nov 26, 2020
Journal Diabetes Care
Print ISSN 0149-5992
Electronic ISSN 1935-5548
Publisher American Diabetes Association
Peer Reviewed Peer Reviewed
Volume 44
Issue 1
Pages 58-66
DOI https://doi.org/10.2337/dc20-1220
Keywords Advanced and Specialized Nursing; Endocrinology, Diabetes and Metabolism; Internal Medicine
Public URL https://nottingham-repository.worktribe.com/output/4978074
Publisher URL https://care.diabetesjournals.org/content/44/1/58
Additional Information This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes Care. The American Diabetes Association (ADA), publisher of Diabetes Care, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of Diabetes Care in print and online at http://care.diabetesjournals.org.

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