Parts of this study were presented at the 47th Annual Meeting of the European Association for the Study of Diabetes, Lisbon, Portugal, September 12–16, 2011.
Association Between Glycemic Control and Hip Fracture
Article first published online: 2 AUG 2012
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 60, Issue 8, pages 1493–1497, August 2012
How to Cite
J Am Geriatr Soc 2012.
NCT01379690, ClinicalTrials.gov Identifier.
Singhealth Centralized Institutional Review Board (CIRB) Ref: 2011/240/C.
- Issue published online: 13 AUG 2012
- Article first published online: 2 AUG 2012
Vol. 61, Issue 1, 174, Article first published online: 11 JAN 2013
- hip fracture;
- glycemic control;
- type 2 diabetes mellitus
To determine whether tight glycemic control is associated with greater risk of hip fractures in individuals being treated for type 2 diabetes mellitus.
Cases were selected from all individuals with diabetes mellitus admitted between 2005 and 2010 to Changi General Hospital for hip fracture (N = 932). Cases were included if their glycosylated hemoglobin (HbA1c) had been measured within 3 months of the fracture and they were undergoing treatment with oral hypoglycemic medications or insulin. Each case was matched with one control for sex, age, race, duration of diabetes mellitus, and comorbidities.
Information on baseline characteristics, HbA1c, and use of diabetic medications was obtained. The likelihood of hip fracture was determined comparing four different values of HbA1c [<6%, 6.1–7.0%, 7.1–8.0%, >8% (reference group)] and use of diabetic medications.
The mean age of cases was 77.3 ± 7.7, and 73.3% were female. After adjusting for age, sex, race, comorbidities, and other covariates, participants with tighter glycemic control (HbA1c < 6% and 6.1–7.0%) were more likely to have a hip fracture than those with HbA1c >8% (odds ratio (OR) = 3.01, 95% confidence interval (CI) = 2.01–4.51, P < .001; and OR = 2.34, 95% CI=1.71–3.22, P < .001, respectively). The use of insulin and sulfonylurea was similar between cases and controls.
The present study found an association between tight glycemic control (when HbA1c < 7%) and greater risk of hip fracture in individuals being treated for type 2 diabetes mellitus. Greater caution needs to be exercised in treating older patients with diabetes mellitus.