Incident Type 2 Diabetes and Risk of Fracture: A Comparative Cohort Analysis Using U.K. Primary Care Records
| Autor: | Gabrielle Davie, Irene Petersen, Edward G Tyrrell, Kingshuk Pal, Elizabeth Orton |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Research design medicine.medical_specialty Endocrinology Diabetes and Metabolism Prevalence 030209 endocrinology & metabolism Type 2 diabetes Lower risk Cohort Studies Fractures Bone 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus Internal Medicine Humans Medicine 030212 general & internal medicine Advanced and Specialized Nursing Primary Health Care business.industry Hazard ratio medicine.disease Diabetes Mellitus Type 2 Cohort Female business Cohort study |
| Zdroj: | Diabetes Care. 44:58-66 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc20-1220 |
| Popis: | OBJECTIVE To estimate risk of fracture in men and women with recent diagnosis of type 2 diabetes compared with individuals without diabetes. RESEARCH DESIGN AND METHODS In this cohort study, we used routinely collected U.K. primary care data from The Health Improvement Network. In adults (>35 years) diagnosed with type 2 diabetes between 2004 and 2013, fractures sustained until 2019 were identified and compared with 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 hazard 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, 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. CONCLUSIONS 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. |
| Databáze: | OpenAIRE |
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