Skip to content

Diabetes Health Center

Font Size

Diabetes Patients May Have Higher Fracture Risk

Study Suggests Bone Mineral Density Testing May Be Useful for Older Diabetes Patients
WebMD Health News
Reviewed by Laura J. Martin, MD

May 31, 2011 -- Older people with type 2 diabetes may have a higher risk for fractures that those without diabetes, even though they tend to have less bone density loss as measured by bone mineral density testing.

This paradox has left many questioning whether bone mineral density testing is of any value in older people with diabetes. Now, a new study, appearing in Wednesday's Journal of the American Medical Association, helps answer this question.

Researchers found that femoral neck bone mineral density (BMD) T scores and World Health Organization Fracture Risk Algorithm (FRAX) scores do predict fracture risk in older patients with diabetes. But doctors must also consider a possible further increase in risk due to diabetes when interpreting these scores.

"We found a clear benefit for testing bone mineral density in older [diabetes patients], but the threshold for concern was lower than for people without diabetes," University of California, San Francisco associate professor of epidemiology and biostatistics Ann V. Schwartz, PhD, tells WebMD.

Diabetes and Fracture Risk

Bone mineral density is most often determined using dual energy X-ray absorptiometry, or DEXA, scanning, which measures the amount of low-energy and high-energy beams that pass through the bone during the X-ray.

A BMD T score measures the density of a patient's bone compared to a normal, healthy 30-year-old. A T score that is within 1 standard deviation of a healthy young adult is considered normal, while a BMD greater than 2.5 standard deviations from normal (-2.5) is the threshold for osteoporosis.

Schwartz and colleagues analyzed data from three prospective observational studies which followed 18,000 older people for an average of around 12 years, including 770 women and close to 1,200 men with type 2 diabetes.

During the follow-up, 84 women with diabetes and 32 men with diabetes experienced hip fractures; 262 women with diabetes and 133 men with diabetes experienced other non-spinal fractures.

Bone mineral density T scores and FRAX scores were both associated with hip and non-spine fracture risk in the diabetes patients.

"A diabetic patient with a T-score of –2.0 had about the fracture risk as a non-diabetic with a T-score of -2.5," Schwartz says.

The new findings confirm that a diabetes patient with a FRAX score of 3% has a higher fracture risk than a non-diabetes patient with the same score, Schwartz says.

Is This Normal? Get the Facts Fast!

Check Your Blood Sugar Level Now
What type of diabetes do you have?
Your gender:

Get the latest Diabetes newsletter delivered to your inbox!


Your level is currently

If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Did You Know Your Lifestyle Choices
Affect Your Blood Sugar?

Use the Blood Glucose Tracker to monitor
how well you manage your blood sugar over time.

Get Started

This tool is not intended for women who are pregnant.

Start Over

Step:  of 

Today on WebMD

Diabetic tools
Symptoms, diagnosis, treatment, and more.
woman flexing muscles
10 strength training exercises.
Blood sugar test
12 practical tips.
Tom Hanks
Stars living with type 1 or type 2.
kenneth fujioka, md
Can Vinegar Treat Diabetes
Middle aged person
Home Healthcare

Prediabetes How to Prevent Type 2 Diabetes
type 2 diabetes
food fitness planner