Baltrusaitis SL, et al. - In this retrospective cohort study, researchers examined the connection between average glycemic control levels and fractures in elderly veterans. Eligible participants were aged ≥ 65 years as of January 1, 2007. Using Chi-square and Cox regression analysis, data from January 1, 2010, to January 1, 2017, from the Veteran’s Affairs Corporate Data Warehouse were analyzed. The investigation included 3,434 fracture events from the 36,744 veterans. In elderly veterans with type 2 diabetes, the average HbA1c 7.1%–8.0% [54–64 mmol/mol], and 8.1–9% [65–75 mmol/mol] have the lowest incidence of fracture, and those without diabetes have the highest incidence rate. However, the absolute difference in fracture incidence was very low at 2–5 per 1,000 patient years due to the overall low rate of fracture. These findings did not support altering diabetes treatment goals to reduce the risk of fracture beyond limiting the risk factors identified. Findings suggested an association of the no-diabetes group with the highest risk of fracture due to the larger sample size, increased prevalence of diagnosis of osteoporosis, alcohol use disorder, and deficiency of vitamin D. This may also be due to the anabolic effects of insulin in type 2 diabetes due to obesity-related insulin resistance.