ArticleThe Journal of clinical endocrinology and metabolism2022
Unmasking Fracture Risk in Type 2 Diabetes: The Association of Longitudinal Glycemic Hemoglobin Level and Medications.
Article in The Journal of clinical endocrinology and metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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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.
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Who cites it
26 citing papers in PubMed, 36 citations in OpenAlex.
- 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
- Pathophysiology, diagnosis and management of secondary osteoporosis.Nature reviews. Endocrinology · 2026Review
- 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- 13. Older Adults: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Ferroptosis-Mediated Cell-Specific Damage: Molecular Cascades and Therapeutic Breakthroughs in Diabetic Retinopathy.Antioxidants (Basel, Switzerland) · 2025Review
- New Aspects of the Pathophysiology of Diabetic Bone Fragility - Type 2 Diabetes Mellitus as a Disease of Accelerated Aging.Current osteoporosis reports · 2025Review
- Postoperative risks of type 2 diabetes in elderly hip fracture patients: a propensity score-matched study.Journal of bone and mineral metabolism · 2025Article
- F2-Isoprostanes Are Associated With Increased Fracture Risk in Type 2 Diabetes.The Journal of clinical endocrinology and metabolism · 2025Observational
- The effects of type 1 and type 2 diabetes mellitus on bone health in chronic kidney disease.Nature reviews. Endocrinology · 2025Review
- Fibroblast growth factor 23 predicts incident diabetic kidney disease: A 4.6-year prospective study.Diabetes, obesity & metabolism · 2025Article
- 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
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- Article
- Review
- The multiple actions of dipeptidyl peptidase 4 (DPP-4) and its pharmacological inhibition on bone metabolism: a review.Diabetology & metabolic syndrome · 2024Review
- Relationship between diabetes treatment status and occupational accidents.Journal of diabetes investigation · 2024Article
- Exploring the Interplay between Vitamin D, Insulin Resistance, Obesity and Skeletal Health.Journal of bone metabolism · 2024Article
- Deep learning-based long-term risk evaluation of incident type 2 diabetes using electrocardiogram in a non-diabetic population: a retrospective, multicentre study.EClinicalMedicine · 2024Article
- 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2024.Diabetes care · 2024Review
- Trabecular Bone Score (TBS) in Individuals with Type 2 Diabetes Mellitus: An Updated Review.Journal of clinical medicine · 2023Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
contextFracture risk is underestimated in people with type 2 diabetes (T2D).
objectiveTo investigate the longitudinal relationship of glycated hemoglobin (HbA1c) and common medications on fracture risk in people with T2D.
methodsThis retrospective population-based cohort study was conducted using de-identified claims and electronic health record data obtained from the OptumLabs Data Warehouse for the period January 1, 2007, to September 30, 2015. For each individual, the study was conducted within a 2-year HbA1c observation period and a 2-year fracture follow-up period. A cohort of 157 439 individuals with T2D [age ≥ 55 years with mean HbA1c value ≥ 6%] were selected from 4 018 250 US Medicare Advantage/Commercial enrollees with a T2D diagnosis. All fractures and fragility fractures were measured.
resultsWith covariates adjusted, poor glycemic control in T2D individuals was associated with an 29% increase of all fracture risk, compared with T2D individuals who had adequate glycemic control (HR: 1.29; 95% CI, 1.22-1.36). Treatment with metformin (HR: 0.88; 95% CI, 0.85-0.92) and DPP4 inhibitors (HR: 0.93; 95% CI, 0.88-0.98) was associated with a reduced all fracture risk, while insulin (HR: 1.26; 95% CI, 1.21-1.32), thiazolidinediones (HR: 1.23; 95% CI, 1.18-1.29), and meglitinides (HR: 1.12; 95% CI, 1.00-1.26) were associated with an increased all fracture risk (All P value < 0.05). Bisphosphonates were associated similarly with increased fracture risk in the T2D and nondiabetic groups.
conclusionLongitudinal 2-year HbA1c is independently associated with elevated all fracture risk in T2D individuals during a 2-year follow-up period. Metformin and DPP4 inhibitors can be used for management of T2D fracture risk.
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Registered trials
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