Insulin use and Excess Fracture Risk in Patients with Type 2 Diabetes: A Propensity-Matched cohort analysis

Abstract 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....

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Autores principales:	Eladio Losada-Grande, Samuel Hawley, Berta Soldevila, Daniel Martinez-Laguna, Xavier Nogues, Adolfo Diez-Perez, Manel Puig-Domingo, Dídac Mauricio, Daniel Prieto-Alhambra
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/97c3e367970e42b28d6fb62632160af3
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spelling	oai:doaj.org-article:97c3e367970e42b28d6fb62632160af32021-12-02T16:06:44ZInsulin use and Excess Fracture Risk in Patients with Type 2 Diabetes: A Propensity-Matched cohort analysis10.1038/s41598-017-03748-z2045-2322https://doaj.org/article/97c3e367970e42b28d6fb62632160af32017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-03748-zhttps://doaj.org/toc/2045-2322Abstract 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.Eladio Losada-GrandeSamuel HawleyBerta SoldevilaDaniel Martinez-LagunaXavier NoguesAdolfo Diez-PerezManel Puig-DomingoDídac MauricioDaniel Prieto-AlhambraNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Eladio Losada-Grande Samuel Hawley Berta Soldevila Daniel Martinez-Laguna Xavier Nogues Adolfo Diez-Perez Manel Puig-Domingo Dídac Mauricio Daniel Prieto-Alhambra Insulin use and Excess Fracture Risk in Patients with Type 2 Diabetes: A Propensity-Matched cohort analysis
description	Abstract 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.
format	article
author	Eladio Losada-Grande Samuel Hawley Berta Soldevila Daniel Martinez-Laguna Xavier Nogues Adolfo Diez-Perez Manel Puig-Domingo Dídac Mauricio Daniel Prieto-Alhambra
author_facet	Eladio Losada-Grande Samuel Hawley Berta Soldevila Daniel Martinez-Laguna Xavier Nogues Adolfo Diez-Perez Manel Puig-Domingo Dídac Mauricio Daniel Prieto-Alhambra
author_sort	Eladio Losada-Grande
title	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_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_sort	insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/97c3e367970e42b28d6fb62632160af3
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Insulin use and Excess Fracture Risk in Patients with Type 2 Diabetes: A Propensity-Matched cohort analysis

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