ArticleDiabetes, metabolic syndrome and obesity : targets and therapy2016
Fracture risk in patients with type 2 diabetes under different antidiabetic treatment regimens: a retrospective database analysis in primary care.
Article in Diabetes, metabolic syndrome and obesity : targets and therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Effect of Newer Long-Acting Insulins on Hypoglycemia and Fracture Risk Among People with Diabetes: A Systematic Review.Current osteoporosis reports · 2021Pooled it
- Sulfonylureas use and fractures risk in elderly patients with type 2 diabetes mellitus: a meta-analysis study.Aging clinical and experimental research · 2021Pooled it
- Glucose-Lowering Drugs and Fracture Risk-a Systematic Review.Current osteoporosis reports · 2020Pooled it
- Bone health in diabetes mellitus.Reviews in endocrine & metabolic disorders · 2026Review
- Fracture events associated with GLP-1 receptor agonists in FDA adverse events reporting system.Acta diabetologica · 2025Article
- Effect of Drugs Used in Pharmacotherapy of Type 2 Diabetes on Bone Density and Risk of Bone Fractures.Medicina (Kaunas, Lithuania) · 2024Review
- Diabetes and bone.Archives of endocrinology and metabolism · 2022Review
- Fracture risk assessment in diabetes mellitus.Frontiers in endocrinology · 2022Review
- Update on the pathogenesis and treatment of skeletal fragility in type 2 diabetes mellitus.Nature reviews. Endocrinology · 2021Review
- Hepatocyte growth factor administration increases bone soluble phosphate and alters bone chemical structure in diabetic hypertensive rats.Journal of materials research · 2021Article
- Critical review of bone health, fracture risk and management of bone fragility in diabetes mellitus.World journal of diabetes · 2021Review
- Incidence of fractures in patients with type 1 diabetes mellitus-a retrospective study with 4420 patients.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Pathophysiology and Management of Type 2 Diabetes Mellitus Bone Fragility.Journal of diabetes research · 2020Review
- Effect of type 2 diabetes medications on fracture risk.Annals of translational medicine · 2019Review
- Stem cell-based bone and dental regeneration: a view of microenvironmental modulation.International journal of oral science · 2019Review
- Insulin use and fracture risk in patients with type 2 diabetes: A meta-analysis of 138,690 patients.Experimental and therapeutic medicine · 2019Article
- The tamoxifen paradox-influence of adjuvant tamoxifen on fracture risk in pre- and postmenopausal women with breast cancer.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Article
- Skeletal Fragility in Type 2 Diabetes Mellitus.Endocrinology and metabolism (Seoul, Korea) · 2018Review
- Oral contraceptive use and fracture risk-a retrospective study of 12,970 women in the UK.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
- Use of dipeptidyl peptidase-4 inhibitors and risk of bone fracture in patients with type 2 diabetes in Germany-A retrospective analysis of real-world data.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimType 2 diabetes is associated with an increased risk of fractures. There are a few studies on the effects of diabetes treatment on fracture risk. The aim was to investigate the fracture risk related to various types of insulin therapy in primary care practices.
methodsData from 105,960 type 2 diabetes patients from 1,072 general and internal medicine practices in Germany were retrospectively analyzed (Disease Analyzer database; 01/2000-12/2013). Fracture risk of the following therapies was compared using multivariate logistic regression models adjusting for age, sex, diabetes care, comorbidity, and glycemic control (HbAlc): 1) incident insulin therapy versus oral antidiabetic drugs, 2) basal-supported oral therapy versus supplementary insulin therapy versus conventional insulin therapy, and 3) insulin glargine versus insulin detemir versus NPH insulin.
resultsThere was a lower odds of having incident fractures in the oral antidiabetic drug group compared to incident insulin users, although not significant (odds ratio [OR]; 95% confidence interval: 0.87; 0.72-1.06). There were increased odds for conventional insulin therapy (OR: 1.59; 95% CI [confidence interval] 0.89-2.84) and supplementary insulin therapy (OR: 1.20; 0.63-2.27) compared to basal-supported oral therapy, which was not significant as well. Overall, there was no significant difference in fracture risk for basal insulins (glargine, detemir, NPH insulin). After a treatment duration ≥2 years, insulin glargine showed a lower odds of having ≥1 fracture compared to NPH users (OR: 0.78; 0.65-0.95) (detemir vs NPH insulin: OR: 1.03; 0.79-1.36).
conclusionLong-standing therapy with insulin glargine was associated with a lower odds of having any fractures compared to NPH insulin. Further studies are required to investigate whether the lower chance is due to a reduced frequency of hypoglycemia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.