Lee RH, Sloane R, Pieper C, et al. - in this retrospective study, 652,901 male veterans aged ≥ 65 years with diabetes and baseline HbA1c value were involved in order to ascertain the relative relationship and possible interactions between HbA1c level and diabetes treatment regimen. In comparison with the reference HbA1c of 7.5% to 8.5%, HbA1c < 6.5% was related to a higher risk of any clinical fracture. Among those with A1c ≥ 8.5% and among those with A1c 6.5% to 7.5%, fracture risk did not rise. The use of insulin was independently correlated with a higher risk of fracture. A notable interaction between insulin use and HbA1c level was seen. Metformin use was related to reduced fracture risk. In summary, those with HbA1c lower than 6.5% among elderly men with diabetes are at heightened risk for any clinical and hip fracture. Moreover, particularly among those with tight glycemic control, insulin use is related to greater fracture risk. Thus, the findings exhibit the significance of the treatment regimen and dodging hypoglycemia for fracture prevention in elderly men with diabetes.