University of Leicester
Browse
1479683X-EuropeanJournalofEndocrinologyHypoglycaemiaisassociatedwithincreasedriskoffracturesinpatientswithtype2diabetesmellitus_acohortstu.pdf (1.16 MB)

Hypoglycaemia is associated with increased risk of fractures in patients with type 2 diabetes mellitus: a cohort study

Download (1.16 MB)
journal contribution
posted on 2019-04-04, 10:11 authored by A Ntouva, KA Toulis, D Keerthy, NJ Adderley, W Hanif, R Thayakaran, K Gokhale, GN Thomas, K Khunti, A Tahrani, K Nirantharakumar
Objective Type 2 diabetes is associated with an increased risk of fracture. Any factor that incrementally increases this risk should be taken into account when individualizing treatment. Hypoglycemia is a common complication of antidiabetes medications and suggested as a risk factor for fractures, yet its real-life clinical impact is unclear. Design A population-based, retrospective open cohort study using routinely collected data between 1st of January 1995 and 1st of May 2016 in The Health Improvement Network. Methods Patients with type 2 diabetes mellitus with documented hypoglycaemic events were compared to randomly matched patients with type 2 diabetes mellitus without documented hypoglycaemic events matched to exposed patients on age, sex, duration of diabetes and BMI. The primary outcome was any incident fracture. Secondary outcome was incident fragility (osteoporotic) fracture. Results A total of 41,163 patients with type 2 diabetes were included: 14,147 patients in the exposed cohort and 27,016 patients in the unexposed cohort. Patients with a documented hypoglycaemic event were significantly more likely to sustain any fracture compared to patients with no record of hypoglycemic events: adjusted IRR 1.20 (95% CI 1.12-1.30; p < 0.0001). Patients who had a documented hypoglycaemic event were significantly more likely to suffer a fragility fracture compared to controls: adjusted IRR 1.24 (95% CI 1.13-1.37; p < 0.0001). Conclusions Hypoglycaemic events are a significant risk factor for fractures in patients with diabetes mellitus. This observation is clinically relevant when individualizing targets for glycaemic control and selecting antidiabetic agents.

History

Citation

Eur J Endocrinol, 2019, 180 (1), pp. 51-58

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Diabetes Research Centre

Version

  • AM (Accepted Manuscript)

Published in

Eur J Endocrinol

Publisher

BioScientifica

eissn

1479-683X

Acceptance date

2018-10-29

Copyright date

2018

Publisher version

https://eje.bioscientifica.com/view/journals/eje/180/1/EJE-18-0458.xml

Notes

The file associated with this record is under embargo until 12 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en

Usage metrics

    University of Leicester Publications

    Categories

    Keywords

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC