Having elevated blood glucose is linked to a higher risk for bone fractures in older adults with type 2 diabetes, according to new research published in the journal Diabetes Care.
Bone fractures can be especially damaging in older adults, who are generally at higher risk for fractures due to higher rates of osteoporosis (having weaker, more porous bones). While most younger people recover fully from bone fractures, older people are much more likely to experience deteriorating health following a fracture, which may lead to death in the most severe cases.
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For the latest analysis, researcher sought to identify factors linked to a higher fracture risk in older adults with type 2. They used data from the Framingham Heart Study, a long-term health study that included two different generations of participants who had their health outcomes tracked for decades. People with type 2 diabetes were identified based on receiving treatment associated with type 2, or having a fasting glucose level higher than 125 mg/dl. A total of 793 people with type 2 diabetes, with an average age of 70, were included in the analysis, 55% of whom were men.
A1C, additional factors linked to fracture risk
During the study period, a total of 106 fractures occurred. Compared with participants under age 60, there was a higher fracture risk with increasing age — 44% higher for participants ages 60 to 70, and 140% higher for those over age 70. Women were also much more likely — 123% more — to experience a fracture than men. And a higher A1C level (a measure of long-term blood glucose control) was linked to a higher fracture risk — compared with an A1C level of 4.5% to just below 6.5%, the fracture risk was 110% higher for an A1cC level of 6.5% to just below 7.5%, and 29% higher for an A1C level of 7.5% to 13.9%. It’s unknown why the risk for fractures was higher in people with an elevated A1C level below 7.5% than it was in people with an even higher A1C level.
Not surprisingly, a history of falling in the past year was also linked to the risk for bone fractures. Compared with participants who didn’t fall, one fall was linked to an 87% higher fracture risk, while falling twice or more was linked to a whopping 229% higher fracture risk. Perhaps surprisingly, bone density (as measured in the femur, where hip fractures are most likely to occur) was not linked to fracture risk, and neither were body-mass index (a measure of body weight that takes height into account), smoking status, chronic diseases other than diabetes, or medication use.
The researchers concluded that out of the factors linked to bone fractures in older people with type 2 diabetes, the single factor in this study that people may have some control over is A1C level. This finding reinforces the importance of blood glucose control in older people with diabetes, showing that bone fractures can be an immediate and devastating consequence of unmanaged blood glucose levels.
Want to learn more about maintaining healthy bones? Read “Better Bone Health With Diabetes,” “Boost Your Bone Health,” and “Diabetes, Bones.”
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