Hip fractures are quite a common occurrence and can happen due to trauma or falls. In younger patients, road traffic accidents or sports injury are usually the cause of hip fracture. For the elderly, hip fractures are more likely to happen even with minor falls or trauma as the bones are not as strong compared to younger individuals. Older patients are also more likely to have osteoporosis which further weakens the bone structure and increases the likelihood of hip fractures when there is minor trauma.
In a research study involving approximately 6400 patients, it was found that patients with type 2 diabetes have a higher risk of hip fracture. Other studies have also found that type 2 diabetics have worse outcomes in hip fractures when compared to those without diabetes. There is also a higher readmission rate after surgical treatment of hip fracture which may be due to poor wound healing and higher infection rates. There is also impaired bone healing in diabetics with hip fractures.
Another study found that both type 1 and type 2 diabetics have a significantly higher risk of hip fracture in women. This is not limited to hip fractures as it was found that the risk of other fractures was also higher.
Although the mechanism of how diabetes is linked to a higher incidence of fractures is still unclear, it has been theorized that it may be due to several factors such as neuropathy and other complications of diabetes like diabetic retinopathy and hypoglycemia. The combination of poor bone health and frequent falls would increase the risk of fracture.
Furthermore, it was found that insulin-treated diabetics have a higher risk of fractures compared to non-insulin treated diabetics. The mechanism for this is also unclear, but it has been theorized that patients who need insulin treatment are more likely to have more advanced diabetes, which may be a contributor to the incidence of risk fractures.
In conclusion, although the current literature has found that both type 1 and 2 diabetes have been linked to a higher risk of fractures (with more literature on hip fractures), the underlying mechanism of why and how it happens is still unclear and more studies, and research is underway.
[expand title=”References“]
Janghorbani M, Feskanich D, Willett WC, Hu F. Prospective study of diabetes and risk of hip fracture. Diabetes Care. 2006; 29(7):1573-1578.
Craven J. Hip fracture risk in type 2 diabetes. Endocrinology Advisor. 2016. Accessed 3/1/2017.
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