Martinez–Laguna D, et al. – This population–based study focused on the absolute and relative excess all–cause mortality following a fracture in type 2 diabetes mellitus (T2DM) patients. Accumulated data displayed 30% increased post–fracture mortality in T2DM patients compared to non–diabetics. Moreover, a remarkable excess in absolute mortality risk was also reported in T2DM patients. However, further research was required on the causes underlying such excess risk, and on the effectiveness of measures to reduce post–fracture morbi–mortality in T2DM subjects.

Methods

• This study applied data from the SIDIAP database.
• All ≥50 years old T2DM patients registered in SIDIAP in 2006–2013 and two diabetes–free controls matched on age, gender, and primary care center were included.
• All–cause mortality following incident fractures was considered as the study outcome.
• Participants were followed from date of any fracture (AF), hip fracture (HF), and clinical vertebral fracture (VF) until the earliest of death or censoring.
• To calculate mortality according to T2DM status after adjustment for age, gender, body mass index, smoking, alcohol intake, and previous ischemic heart and cerebrovascular disease, Cox regression was used.

Results

• Outcomes revealed that 166,106 T2DM patients and 332,212 non–diabetic, of which 11,066 and 21,564, respectively, sustained a fracture and were then included.
• As per the results, post–fracture mortality rates (1000 person–years) were (in T2DM vs non–diabetics) 62.7 vs 49.5 after AF, 130.7 vs 112.7 after HF, and 54.9 vs 46.2 after VF.
• For T2DM, adjusted HR (95% CI) for post–AF, post–HF, and post–VF mortality was 1.30 (1.23–1.37), 1.28 (1.20–1.38), and 1.20 (1.06–1.35), respectively, compared to non–diabetics.