Fracture risk by post-cessation weight change in male patients with newly diagnosed type 2 diabetes mellitus.

OBJECTIVE

This study aimed to evaluate the conflicting effects of weight change and smoking cessation on fracture risk in male patients with newly diagnosed type 2 diabetes mellitus (T2DM).

METHODS

Using the National Health Insurance Service database, we analyzed 43,564 male patients with newly diagnosed T2DM (2009-2015) who underwent health examinations within ± 2 years of diagnosis. Participants were classified as continual smokers or quitters with no body mass index (BMI) change, BMI gain, or BMI loss. Cox proportional hazards regression was utilized to calculate adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the risk of fracture.

RESULTS

Smoking cessation was not associated with a lower fracture risk compared with continual smoking (aHR, 0.94; 95% CI, 0.81-1.09). Quitters with stable weight had reduced risk (aHR, 0.78; 95% CI, 0.64-0.96); risks were higher with both weight gain and loss, especially loss.

CONCLUSION

In male patients with newly diagnosed T2DM, smoking cessation did not reduce fracture risk, but weight maintenance after cessation was protective. Weight loss after cessation significantly increased fracture risk, highlighting the need for integrated weight management.