ArticleDiabetes care2013
High bone mineral density and fracture risk in type 2 diabetes as skeletal complications of inadequate glucose control: the Rotterdam Study.
Article in Diabetes care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 223 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
223 citing papers in PubMed, 7 syntheses or guidelines pooled it, 383 citations in OpenAlex.
- Association between type 2 diabetes and site-specific fracture risk: A systematic review and meta-analysis of cohort studies including over 13 million participants.Diabetic medicine : a journal of the British Diabetic Association · 2026Pooled it
- The Effect of Type 2 Diabetes on Bone Quality: A Systematic Review and Meta-Analysis of Cohort Studies.International journal of environmental research and public health · 2025Pooled it
- The association of coffee consumption with the risk of osteoporosis and fractures: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Pooled it
- Vertebral Fractures in Individuals With Type 2 Diabetes: More Than Skeletal Complications Alone.Diabetes care · 2020Pooled it
- Pooled it
- Discordant pattern of peripheral fractures in diabetes: a meta-analysis on the risk of wrist and ankle fractures.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Pooled it
- Diabetes mellitus and risk of hip fractures: a meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Pooled it
- Trial
- Predictors of Fracture in Middle-Aged and Older Adults With Type 2 Diabetes and Overweight or Obesity.The Journal of clinical endocrinology and metabolism · 2025Trial
- Factors associated with fragility fractures in type 2 diabetes: An analysis of the randomised controlled Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.Diabetes/metabolism research and reviews · 2023Trial
- Hemoglobin A1c Threshold for Reduction in Bone Turnover in Men With Type 2 Diabetes Mellitus.Frontiers in endocrinology · 2021Trial
- Circulating Gut Microbiota Metabolite Trimethylamine N-Oxide (TMAO) and Changes in Bone Density in Response to Weight Loss Diets: The POUNDS Lost Trial.Diabetes care · 2019Trial
- The effect of high-dose vitamin DOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Trial
- Type 2 Diabetes and Longitudinal Changes in Cortical and Trabecular Bone Density, Microarchitecture, and Strength: The Framingham Study.Diabetes care · 2026Article
- Mandibular trabecular fractal dimension in individuals with type 2 diabetes and hypertension: a retrospective cross-sectional panoramic radiography study.BMC oral health · 2026Article
- Polypharmacy and Bone Health in Patients with Type 2 Diabetes Mellitus: A Narrative Review.Journal of bone metabolism · 2026Article
- Not all prediabetes is the same in its effect for bone health.The Korean journal of internal medicine · 2026Article
- Advanced glycation end-products and sclerostin are elevated across diabetes phenotypes and associated with vertebral fractures in type 2 diabetes.BMC endocrine disorders · 2026Article
- Differences and similarities in cortical bone of the femur between donors with and without type 2 diabetes.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Visceral Adiposity, Rather than Reduced Appendicular Lean Mass, Characterizes Elderly Hip Fracture Patients with Type 2 Diabetes: A Cross-Sectional DXA Analysis.Journal of clinical medicine · 2026Article
163 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIndividuals with type 2 diabetes have increased fracture risk despite higher bone mineral density (BMD). Our aim was to examine the influence of glucose control on skeletal complications. RESEARCH DESIGN AND
methodsData of 4,135 participants of the Rotterdam Study, a prospective population-based cohort, were available (mean follow-up 12.2 years). At baseline, 420 participants with type 2 diabetes were classified by glucose control (according to HbA1c calculated from fructosamine), resulting in three comparison groups: adequately controlled diabetes (ACD; n = 203; HbA1c <7.5%), inadequately controlled diabetes (ICD; n = 217; HbA1c ≥ 7.5%), and no diabetes (n = 3,715). Models adjusted for sex, age, height, and weight (and femoral neck BMD) were used to test for differences in bone parameters and fracture risk (hazard ratio [HR] [95% CI]).
resultsThe ICD group had 1.1-5.6% higher BMD, 4.6-5.6% thicker cortices, and -1.2 to -1.8% narrower femoral necks than ACD and ND, respectively. Participants with ICD had 47-62% higher fracture risk than individuals without diabetes (HR 1.47 [1.12-1.92]) and ACD (1.62 [1.09-2.40]), whereas those with ACD had a risk similar to those without diabetes (0.91 [0.67-1.23]).
conclusionsPoor glycemic control in type 2 diabetes is associated with fracture risk, high BMD, and thicker femoral cortices in narrower bones. We postulate that fragility in apparently "strong" bones in ICD can result from microcrack accumulation and/or cortical porosity, reflecting impaired bone repair.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.