Hip Fracture, recent epidemic of diabetes mellitus along with advancements in the treatment of diabetes and its complications have led to a rapid increase in the number of aged patients with diabetes. A better understanding of geriatrics is needed in the clinical management of patients with diabetes. Osteoporosis occurs with aging and increases the risk of fragility fractures, which cause other comorbidities or increase mortality in persons of advance age.
Correlations of hip fracture
Epidemiological studies have reveal an increase risk of hip or other fractures in patients; so with than without type 2 diabetes. This is partly explain by non-enzymatic glycation of the collagen within bones; so decrease bone turnover, oxidative stress, and adverse effects of certain diabetes medications. For patients with type 2 diabetes, hip fracture is associate with an increased risk for death; so according to a study publish online May 21 in the Journal of Diabetes Investigation.
Yuji Komorita, M.D., Ph.D., from Kyushu University in Fukuoka, Japan, and colleagues examine the correlations of hip fracture, upper-limb fracture, cardiovascular disease (CVD), and end-stage renal disease (ESRD) with all-cause death in patients with type 2 diabetes. A total of 4,923 Japanese patients with type 2 diabetes were follow for a median of 5.3 years.
The researchers found that during follow-up, 309 participants died. Participants with hip fracture versus those without had increase multivariate-adjust odds ratios (ORs) for all-cause mortality (OR, 2.67). The ORs for upper-limb fractures were not significant. Patients with CVD and ESRD versus those without had significantly higher ORs for all-cause mortality (ORs, 1.78 and 2.36, respectively).
Cause of death was infection
Further adjustment for CVD and ESRD did not affect the OR for all cause mortality; so associate with hip fracture (OR, 2.74). Among participants with hip fracture, the cause of death was infection, malignant neoplasm, and CVD (40, 25, and 15 percent, respectively). It should be emphasize that hip fracture is a critical event in the aging population of patients; so with type 2 diabetes during the present era of a better prognosis of CVD,” the authors write.
The main strength of the present study is the high follow-up rate of death (99.5%); which enable us to accurately determine the associations of hip fracture or other diabetes relate complications with death; so against the background that the follow-up of patients with severe comorbidities may be difficult
Our study demonstrate that the presence of hip fracture was associate with an increase risk of death; hence among Japanese patients with type 2 diabetes, independently of CVD and ESRD. It should be emphasize that hip fracture is a critical event in the aging population of patients; so with type 2 diabetes during the present era of a better prognosis of CVD. In addition, whether prevention of hip fracture may improve the survival of patients with type 2 diabetes remains to be determined.