Hip and distal arm fracture rates in peri- and postmenopausal insulin-treated diabetic females.

OBJECTIVES

Hip and distal arm fractures are associated with osteoporosis in the postmenopausal female. In diabetic patients, bone mass has been found to be reduced leading to the hypothesis that diabetes is a risk factor for osteoporosis. Whether this has any clinical implication has only been sparsely elucidated.

DESIGN

A cross-sectional case-control study.

SETTING

All insulin-treated diabetic females above the age of 40 years who regularly visited the Steno Memorial Hospital out-patient clinic in 1989. Peri-and postmenopausal females from the general population living in a similar suburban region of Copenhagen admitted to Glostrup University Hospital because of a hip or Colles' fracture between 1 January 1989 and 31 October 1990.

SUBJECTS: The study comprised 748 insulin-treated diabetic females. Thirty hip fractures and 82 Colles' fractures were reported after the age of 40 years. Out of 26,564 females from the general population, 622 were admitted to Glostrup hospital because of a hip or Colles' fracture. METHODS/INTERVENTION: Answers based on questionnaires sent to all diabetic females, and the use of hospital files and hospital registers.

RESULTS

In diabetic females aged 40-49 years, Colles' fracture rate was 2/1000 years and hip fracture rate 0.43/1000 years. Fracture rate increased with age and, amongst 80-89-year-old diabetic females, the frequency of both fracture rates was 31/1000 years. These rates were slightly lower than the rates in the general female population. The relative risk of Colles' fracture in diabetic females aged 40-49 years was 0.3 +/- 0.2 (95% confidence limits) and that of hip fracture 1.0 +/- 1.1. In diabetic females aged 80-89 years, the risk of Colles' fracture and hip fracture were 1.3 +/- 1.1 and 1.0 +/- 0.9. Fracture rate was not associated with the development of diabetic complications, long-term metabolic control, or age at diagnosis.

CONCLUSION

Our results suggest that diabetic osteopenia does not have any clinical impact on fracture risk.