Endocrine Abstracts

Introduction: Recent evidence suggests that the skeleton might be another affected organ in patients with type 2 diabetes mellitus (T2DM). This study evaluates the prevalence of low-traumatic vertebral and non-vertebral fractures and their risk factors in subjects with T2DM.

Materials and methods: We invited outpatients with T2DM, who were under observation in a single outpatient clinic. The subjects were interviewed regarding the presence of low-traumatic fractures and underwent lateral X-ray imaging from T4 to L5. Age, sex, postmenopause and disease duration, complications, HbA1c, calcium intake, risk factors for fracture (FRAX) were registered. Handgrip strength was measured by dynamometer.

Results: Two hundred (141, 70.5% females) consecutive T2DM patients were enrolled. The median of age (Q25–Q75) 66 (60–74 years), BMI 31 (27–36) kg/m², disease duration 8 (4–14) years (neuropathy was diagnosed in 113 patients, retinopathy-94, nephropathy-8), HbA1c 7.4% (6.7–8.5). Fractures were reported in 68 (34%) patients, in 26 (13%) cases there were vertebral fractures and in 52 (26%) low-traumatic non-vertebral fractures. In 10 cases multiple fractures both vertebral and/or non-vertebral were registered. The most frequent fractures were of low-extremities including 2 hip and 26 shin fractures; the upper-extremities were the next most frequent location including 3 humerus, 19 wrist and 4 ulna fractures. Subjects with any fractures were older P=0.004, but did not differ in disease duration P=0.196, HbA1c P=0.99, or calcium intake P=0.62. It seems that subjects with retinopathy fractured more −42.9% as compared to patients without retinopathy −27.6% P=0.001, no difference in any other complications were found. Subjects with fracture had lower grip strength in both hands 30.0 (24.6–39.5) vs 26.5 (22.7–31.5) dAN P=0.019 right hand; 27.7 (22.1–37.5) vs 25.0 (20.0–31.8) dAN left hand P=0.013.

Conclusions: Patients with T2DM have high prevalence of low-traumatic fractures (34%), mostly of low-extremities, which might be related to both ageing and general frailty as well as diabetes complications such as retinopathy.