Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis
Despite normal to high bone mineral density, patients with type 2 diabetes (T2DM) have an increased fracture risk. T2DM medications could partially account for this excess risk. The aim of this study was to assess the association between insulin use and bone fracture risk in T2DM patients. A populat...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Springer Nature
2017
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| _version_ | 1797094693090099200 |
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| author | Losada-Grande, E Hawley, S Soldevila, B Martinez-Laguna, D Nogues, X Diez-Perez, A Puig-Domingo, M Mauricio, D Prieto-Alhambra, D |
| author_facet | Losada-Grande, E Hawley, S Soldevila, B Martinez-Laguna, D Nogues, X Diez-Perez, A Puig-Domingo, M Mauricio, D Prieto-Alhambra, D |
| author_sort | Losada-Grande, E |
| collection | OXFORD |
| description | Despite normal to high bone mineral density, patients with type 2 diabetes (T2DM) have an increased fracture risk. T2DM medications could partially account for this excess risk. The aim of this study was to assess the association between insulin use and bone fracture risk in T2DM patients. A population-based matched cohort study based on a primary care records database validated for research use (Catalonia, Spain) was performed. Propensity score (PS) for insulin use was calculated using logistic regression including predefined predictors of fractures. A total of 2,979 insulin users and 14,895 non-users were observed for a median of 1.42 and 4.58 years respectively. Major fracture rates were 11.2/1,000 person-years for insulin users, compared with 8.3/1,000 among non-users. Matched models confirmed a significant association, with an adjusted subhazard ratio (adj SHR) of 1.38 [95% CI 1.06 to 1.80] for major fractures. No differences between types of insulin or different regimens were found. Estimated number needed to harm (fracture) was 82 (95% CI 32 to 416). Insulin use appears to be associated with a 38% excess fracture risk among T2DM patients in the early stages of the disease. Fracture risk should be included among the considerations to initiate insulin treatment. |
| first_indexed | 2024-03-07T04:17:33Z |
| format | Journal article |
| id | oxford-uuid:c9e57f95-12c6-4cc7-a16b-03eccc431ea0 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:17:33Z |
| publishDate | 2017 |
| publisher | Springer Nature |
| record_format | dspace |
| spelling | oxford-uuid:c9e57f95-12c6-4cc7-a16b-03eccc431ea02022-03-27T07:03:19ZInsulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c9e57f95-12c6-4cc7-a16b-03eccc431ea0EnglishSymplectic Elements at OxfordSpringer Nature2017Losada-Grande, EHawley, SSoldevila, BMartinez-Laguna, DNogues, XDiez-Perez, APuig-Domingo, MMauricio, DPrieto-Alhambra, DDespite normal to high bone mineral density, patients with type 2 diabetes (T2DM) have an increased fracture risk. T2DM medications could partially account for this excess risk. The aim of this study was to assess the association between insulin use and bone fracture risk in T2DM patients. A population-based matched cohort study based on a primary care records database validated for research use (Catalonia, Spain) was performed. Propensity score (PS) for insulin use was calculated using logistic regression including predefined predictors of fractures. A total of 2,979 insulin users and 14,895 non-users were observed for a median of 1.42 and 4.58 years respectively. Major fracture rates were 11.2/1,000 person-years for insulin users, compared with 8.3/1,000 among non-users. Matched models confirmed a significant association, with an adjusted subhazard ratio (adj SHR) of 1.38 [95% CI 1.06 to 1.80] for major fractures. No differences between types of insulin or different regimens were found. Estimated number needed to harm (fracture) was 82 (95% CI 32 to 416). Insulin use appears to be associated with a 38% excess fracture risk among T2DM patients in the early stages of the disease. Fracture risk should be included among the considerations to initiate insulin treatment. |
| spellingShingle | Losada-Grande, E Hawley, S Soldevila, B Martinez-Laguna, D Nogues, X Diez-Perez, A Puig-Domingo, M Mauricio, D Prieto-Alhambra, D Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis |
| title | Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis |
| title_full | Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis |
| title_fullStr | Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis |
| title_full_unstemmed | Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis |
| title_short | Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis |
| title_sort | insulin use and excess fracture risk in patients with type 2 diabetes a propensity matched cohort analysis |
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