Visit-to-visit variation of fasting plasma glucose is a predictor of hip fracture in older persons with type 2 diabetes: the Taiwan Diabetes Study |
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Authors: | J I-H Chiang T-C Li C-I Li C-S Liu N-H Meng W-Y Lin S-Y Yang H-J Chen C-C Lin |
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Institution: | 1.Department of General Practice, Faculty of Medicine, Dentistry & Health Sciences,The University of Melbourne,Melbourne,Australia;2.Graduate Institute of Biostatistics, College of Public Health,China Medical University,Taichung,Taiwan;3.Department of Healthcare Administration, College of Medical and Health Science,Asia University,Taichung,Taiwan;4.School of Medicine, College of Medicine,China Medical University,Taichung,Taiwan;5.Department of Medical Research,China Medical University Hospital,Taichung,Taiwan;6.Department of Family Medicine,China Medical University Hospital,Taichung,Taiwan;7.Department of Physical Medicine and Rehabilitation,China Medical University Hospital,Taichung,Taiwan;8.Management Office for Health Data,China Medical University Hospital,Taichung,Taiwan |
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Abstract: | SummaryWe investigated the association between fasting plasma glucose variability (FPG-CV) and the risk of hip fracture in elderly diabetic patients. Our finding showed a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures.IntroductionHip fracture is a major health burden in the population and is associated with high rates of mortality and morbidity especially in elderly. It is evident that diabetes mellitus is a risk factor of osteoporosis which is a significant risk factor of hip fracture. However, epidemiological studies exploring the risks of hip fracture among type 2 diabetic patients are limited.MethodsA retrospective study of 26,501 ethnic Chinese older persons enrolled in the National Diabetes Care Management program in Taiwan was conducted; related factors were analyzed with extended Cox proportional hazards regression models to competing risk data on hip fracture incidence.ResultsThe results show a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures, confirming a linear relationship between the two. After multivariate adjustment, the risk of hip fracture increased among patients with FPG-CV of 25.4–42.3 % and >42.3 % compared with patients with FPG-CV of ≦ 14.3 % (hazard ratio, 1.35; 95 % confidence interval 1.14–1.60 and 1.27; 1.07–1.52, respectively). Significant linear trends among various FPG-CV were observed.ConclusionsThus, the present study demonstrated the importance of glucose stability for fracture prevention in older persons with type 2 diabetes. Future studies should be conducted to explore whether reduction in glucose oscillation in older adults with diabetes mellitus can reduce the risk of hip fracture. |
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