Use of glucose-lowering drugs and risk of fracture in patients with type 2 diabetes
Abstract Background Diabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering drugs influence the risk of hip fracture in patients with incident diabetes. Methods A study was performed on a cohort of patients with...
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Published in | Bone (New York, N.Y.) Vol. 95; pp. 136 - 142 |
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Format | Journal Article |
Language | English |
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01.02.2017
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Abstract | Abstract Background Diabetes mellitus is associated with an increased risk of hip fracture. The aim of
this cohort study was to investigate whether glucose-lowering drugs influence the risk of hip fracture in patients with incident diabetes. Methods A study was performed on a cohort of patients with incident type 2 diabetes. Diabetes diagnosis was defined using information from the Danish National Patient Registry and reimbursement information of glucose-lowering drugs from the Register of Medicinal Product Statistics. The period of observation was from 01.01.1996 till 31.12.2011. The primary exposure was glucose-lowering drugs and the primary endpoint was hip fracture. Unadjusted, adjusted, and propensity score adjusted Cox regressions were performed. Results 5
244 patients with type 2 diabetes with a mean follow up of 5.5 years were included in the study. Use of sulphonylureas within the last 90 days was associated with hip fracture in patients with type 2 diabetes, hazard ratio 1.64 (95
% confidence interval: 1.54,1.75), whereas ever use of sulohonylyreas was not associated with an increased risk of fractures. Use of sulphonylureas within the last 90 days was also associated with an increased risk of fractures at other sites. Use of glitazones within the last 90 days was associated with an increased risk of hip fracture, hazard ratio 2.07 (95
% confidence interval: 1.39,3.07), whereas ever use was not associated with an increased risk. Conclusions Current use of sulphonylureas was associated with hip fracture in patients with type 2 diabetes. Speculatively, this may be due to hypoglycemia resulting in falls. |
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AbstractList | Background Diabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering drugs influence the risk of hip fracture in patients with incident diabetes. Methods A study was performed on a cohort of patients with incident type 2 diabetes. Diabetes diagnosis was defined using information from the Danish National Patient Registry and reimbursement information of glucose-lowering drugs from the Register of Medicinal Product Statistics. The period of observation was from 01.01.1996 till 31.12.2011. The primary exposure was glucose-lowering drugs and the primary endpoint was hip fracture. Unadjusted, adjusted, and propensity score adjusted Cox regressions were performed. Results 5244 patients with type 2 diabetes with a mean follow up of 5.5years were included in the study. Use of sulphonylureas within the last 90days was associated with hip fracture in patients with type 2 diabetes, hazard ratio 1.64 (95% confidence interval: 1.54,1.75), whereas ever use of sulohonylyreas was not associated with an increased risk of fractures. Use of sulphonylureas within the last 90days was also associated with an increased risk of fractures at other sites. Use of glitazones within the last 90days was associated with an increased risk of hip fracture, hazard ratio 2.07 (95% confidence interval: 1.39,3.07), whereas ever use was not associated with an increased risk. Conclusions Current use of sulphonylureas was associated with hip fracture in patients with type 2 diabetes. Speculatively, this may be due to hypoglycemia resulting in falls. Abstract Background Diabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering drugs influence the risk of hip fracture in patients with incident diabetes. Methods A study was performed on a cohort of patients with incident type 2 diabetes. Diabetes diagnosis was defined using information from the Danish National Patient Registry and reimbursement information of glucose-lowering drugs from the Register of Medicinal Product Statistics. The period of observation was from 01.01.1996 till 31.12.2011. The primary exposure was glucose-lowering drugs and the primary endpoint was hip fracture. Unadjusted, adjusted, and propensity score adjusted Cox regressions were performed. Results 5 244 patients with type 2 diabetes with a mean follow up of 5.5 years were included in the study. Use of sulphonylureas within the last 90 days was associated with hip fracture in patients with type 2 diabetes, hazard ratio 1.64 (95 % confidence interval: 1.54,1.75), whereas ever use of sulohonylyreas was not associated with an increased risk of fractures. Use of sulphonylureas within the last 90 days was also associated with an increased risk of fractures at other sites. Use of glitazones within the last 90 days was associated with an increased risk of hip fracture, hazard ratio 2.07 (95 % confidence interval: 1.39,3.07), whereas ever use was not associated with an increased risk. Conclusions Current use of sulphonylureas was associated with hip fracture in patients with type 2 diabetes. Speculatively, this may be due to hypoglycemia resulting in falls. Diabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering drugs influence the risk of hip fracture in patients with incident diabetes. A study was performed on a cohort of patients with incident type 2 diabetes. Diabetes diagnosis was defined using information from the Danish National Patient Registry and reimbursement information of glucose-lowering drugs from the Register of Medicinal Product Statistics. The period of observation was from 01.01.1996 till 31.12.2011. The primary exposure was glucose-lowering drugs and the primary endpoint was hip fracture. Unadjusted, adjusted, and propensity score adjusted Cox regressions were performed. 5244 patients with type 2 diabetes with a mean follow up of 5.5years were included in the study. Use of sulphonylureas within the last 90days was associated with hip fracture in patients with type 2 diabetes, hazard ratio 1.64 (95% confidence interval: 1.54,1.75), whereas ever use of sulohonylyreas was not associated with an increased risk of fractures. Use of sulphonylureas within the last 90days was also associated with an increased risk of fractures at other sites. Use of glitazones within the last 90days was associated with an increased risk of hip fracture, hazard ratio 2.07 (95% confidence interval: 1.39,3.07), whereas ever use was not associated with an increased risk. Current use of sulphonylureas was associated with hip fracture in patients with type 2 diabetes. Speculatively, this may be due to hypoglycemia resulting in falls. BACKGROUNDDiabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering drugs influence the risk of hip fracture in patients with incident diabetes.METHODSA study was performed on a cohort of patients with incident type 2 diabetes. Diabetes diagnosis was defined using information from the Danish National Patient Registry and reimbursement information of glucose-lowering drugs from the Register of Medicinal Product Statistics. The period of observation was from 01.01.1996 till 31.12.2011. The primary exposure was glucose-lowering drugs and the primary endpoint was hip fracture. Unadjusted, adjusted, and propensity score adjusted Cox regressions were performed.RESULTS5244 patients with type 2 diabetes with a mean follow up of 5.5years were included in the study. Use of sulphonylureas within the last 90days was associated with hip fracture in patients with type 2 diabetes, hazard ratio 1.64 (95% confidence interval: 1.54,1.75), whereas ever use of sulohonylyreas was not associated with an increased risk of fractures. Use of sulphonylureas within the last 90days was also associated with an increased risk of fractures at other sites. Use of glitazones within the last 90days was associated with an increased risk of hip fracture, hazard ratio 2.07 (95% confidence interval: 1.39,3.07), whereas ever use was not associated with an increased risk.CONCLUSIONSCurrent use of sulphonylureas was associated with hip fracture in patients with type 2 diabetes. Speculatively, this may be due to hypoglycemia resulting in falls. Diabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering drugs influence the risk of hip fracture in patients with incident diabetes. A study was performed on a cohort of patients with incident type 2 diabetes. Diabetes diagnosis was defined using information from the Danish National Patient Registry and reimbursement information of glucose-lowering drugs from the Register of Medicinal Product Statistics. The period of observation was from 01.01.1996 till 31.12.2011. The primary exposure was glucose-lowering drugs and the primary endpoint was hip fracture. Unadjusted, adjusted, and propensity score adjusted Cox regressions were performed. 5244 patients with type 2 diabetes with a mean follow up of 5.5years were included in the study. Use of sulphonylureas within the last 90days was associated with hip fracture in patients with type 2 diabetes, hazard ratio 1.64 (95% confidence interval: 1.54,1.75), whereas ever use of sulohonylyreas was not associated with an increased risk of fractures. Use of sulphonylureas within the last 90days was also associated with an increased risk of fractures at other sites. Use of glitazones within the last 90days was associated with an increased risk of hip fracture, hazard ratio 2.07 (95% confidence interval: 1.39,3.07), whereas ever use was not associated with an increased risk. Current use of sulphonylureas was associated with hip fracture in patients with type 2 diabetes. Speculatively, this may be due to hypoglycemia resulting in falls. •Current use of sulphonylureas was associated with an increased risk of fracture in both male and female patients.•Current use of glitazones was associated with an increased risk of fracture in both men and women.•Ever use of sulphonylureas was not associated with an increased risk of fracture in patients with type 2 diabetes.•Advanced age, previous major osteoporotic fractures, falls and were all associated with an increased risk of fracture. |
Author | Starup-Linde, Jakob, PhD Frost, Morten, PhD Vestergaard, Peter, PhD Gregersen, Søren, PhD |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27890548$$D View this record in MEDLINE/PubMed |
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Keywords | International Classification of Diseases anatomical therapeutic classification GLP-1 CCI S ulphonylureas HR Fracture ICD Charlson comorbidity index ATC G lucose-lowering drugs dipeptidyl peptidase IV inhibitors glucagon like peptide-1 DPPIV-i hazard ratio H ip fracture T ype 2 diabetes mellitus Glucose-lowering drugs Hip fracture Sulphonylureas Type 2 diabetes mellitus |
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Snippet | Abstract Background Diabetes mellitus is associated with an increased risk of hip fracture. The aim of
this cohort study was to investigate whether... Diabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering drugs... BACKGROUNDDiabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering... Background Diabetes mellitus is associated with an increased risk of hip fracture. The aim of this cohort study was to investigate whether glucose-lowering... |
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SubjectTerms | Confidence Intervals Diabetes Mellitus, Type 2 - drug therapy Female Fracture Fractures, Bone - chemically induced Fractures, Bone - epidemiology Glucose-lowering drugs Hip fracture Hip Fractures - chemically induced Hip Fractures - epidemiology Humans Hypoglycemic Agents - adverse effects Hypoglycemic Agents - therapeutic use Incidence Male Middle Aged Orthopedics Risk Factors Sulfonylurea Compounds - adverse effects Sulfonylurea Compounds - therapeutic use Sulphonylureas Type 2 diabetes mellitus |
Title | Use of glucose-lowering drugs and risk of fracture in patients with type 2 diabetes |
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