Lee RH, Sloane R, Pieper C, et al. - In this retrospective study involving 652,901 male veterans (aged ≥ 65 years) with diabetes and baseline hemoglobin A1c (HbA1c) value, researchers determined how glycemic control and insulin treatment influences and modifies fracture risk in older men with type 2 diabetes mellitus. They noted that, among older men with diabetes, those with HbA1c below 6.5% had an increased risk of clinical and hip fractures. In addition, use of metformin was associated with a lower risk of fracture. Insulin use was associated with increased risk of fracture, particularly among those with tight glycemic control. In older men with diabetes, the importance of the treatment regimen and avoiding hypoglycemia for fracture prevention was demonstrated.