Type 2 Diabetes May Increase Fracture Risk in Older People

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BOSTON – Though seniors with type 2 diabetes (T2D) tend to have normal or higher bone density than their peers, researchers have found that they are more likely to succumb to fractures than seniors without T2D. In a new study published in the Journal of Bone and Mineral Research, researchers from Hebrew SeniorLife's Institute for Aging Research found older adults with type 2 diabetes had deficits in cortical bone--the dense outer surface of bone that forms a protective layer around the internal cavity-- compared to non-diabetics. The findings suggest that the microarchitecture of cortical bone may be altered in seniors with T2D and thereby place them at increased risk of fracture.

Participants in this study included over 1,000 member of the Framingham Study who were examined over a period of 3 years. High resolution scanning allowed researchers to determine that many older adults with diabetes had weakness specific to cortical bone microarchitecture that cannot be measured by standard bone density testing.

Osteoporotic fractures are a significant public health problem that can lead to disability, decreased quality of life, and even death - not to mention significant health care costs. Risk of fracture is even greater in adults with T2D, including a 40 - 50% increased risk of hip fracture - the most serious of osteoporotic fractures.

"Fracture in older adults with type 2 diabetes is a highly important public health problem and will only increase with the aging of the population and growing epidemic of diabetes. Our findings identify skeletal deficits that may contribute to excess fracture risk in older adults with diabetes and may ultimately lead to new approaches to improve prevention and treatment," said Dr. Elizabeth Samelson, lead author of the study.

Researchers hope that novel studies such as this will help to revolutionize the area of bone health, especially for older adults. It is important to follow screening guidelines for bone density testing, but better understanding of all the factors that affect bone strength and the tendency to fracture is needed.

This study was supported by the National Institute of Arthritis Musculoskeletal and Skin Diseases of the National Institutes of Health under Award R01AR061445 and the National Heart, Lung and Blood Institute's Framingham Heart Study under Contract N01-HC-25195, HHSN2682015000011. Additional support was provided by Friends of Hebrew SeniorLife and Investigator Initiated Studies Program of Merck, Sharp, & Dohme.

About Institute for Aging Research

Scientists at the Institute for Aging Research seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity and productivity into advanced age. The Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment and cure of disease; advance the standard of care for older people; and inform public decision-making. The Musculoskeletal Center within IFAR studies conditions affecting bone, muscle, and joint health with aging.

About Hebrew SeniorLife

Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching and redefining the possibilities of aging. Based in Boston, the non-profit, non-sectarian organization has provided communities and health care for seniors, research into aging, and education for geriatric care providers since 1903. For more information about Hebrew SeniorLife, visit http://www.hebrewseniorlife.org, follow us on Twitter @H_SeniorLife, like us on Facebook or read our blog.