Insulin use and Excess Fracture Risk in Patients with Type 2 Diabetes: A Propensity-Matched cohort analysis
Losada-Grande, Eladio (Universitat Autònoma de Barcelona. Departament de Medicina)
Hawley, Samuel (University of Oxford)
Soldevila i Madorell, Berta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Martínez-Laguna, Daniel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Nogués Solán, Xavier (Institut Hospital del Mar d'Investigacions Mèdiques)
Díez Pérez, Adolfo (Institut Hospital del Mar d'Investigacions Mèdiques)
Puig Domingo, Manuel (Universitat Autònoma de Barcelona. Departament de Medicina)
Mauricio Puente, Dídac (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Prieto-Alhambra, Daniel (University of Oxford)

Date:	2017
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.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Scientific reports, Vol. 3 Núm. 378 (june 2017) , p. 1-9, ISSN 2045-2322

DOI: 10.1038/s41598-017-03748-z
PMID: 28630427

9 p, 1.3 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
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