Risk Factors for Incident Fracture in Older Adults With Type 2 Diabetes: The Framingham Heart Study

Dufour, Alyssa B.; Kiel, Douglas P.; Williams, Setareh A.; Weiss, R. J.; Samelson, Elizabeth J.

doi:10.2337/dc20-3150

Cited by 24 publications

(20 citation statements)

References 42 publications

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“…Older patients with T2DM are at a particularly high-risk of CVD [ 21 ]. However, other conditions that can increase the risk of frailty [ 22 ], fracture [ 23 ], and renal failure [ 24 ] also coexist in elderly patients. Although SGLT2i is well-tolerated, there are concerns related to volume depletion by the diuretic effect of SGLT2i that can lead to postural hypotension and syncope, especially in patients with older age.…”

Section: Discussionmentioning

confidence: 99%

Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease

Baek

Yang

et al. 2022

Diabetes Metab J

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Background: To evaluate prescription trends and clinical factors of the sodium-glucose cotransporter 2 inhibitors (SGLT2i) use according to the presence of atherosclerotic cardiovascular disease (ASCVD) or heart failure (HF) in Korean patients with type 2 diabetes mellitus (T2DM).Methods: Prescription patterns of SGLT2i use between 2015 and 2019 were determined using the Korean National Health Insurance Service database of claims.Results: Of all patients with T2DM (n=4,736,493), the annual prescription rate of SGLT2i increased every year in patients with ASCVD (from 2.2% to 10.7%) or HF (from 2.0% to 11.1%). After the first hospitalization for ASCVD (n=518,572), 13.7% (n=71,259) of patients initiated SGLT2i with a median of 10.6 months. After hospitalization for HF (n=372,853), 11.2% (n=41,717) of patients initiated SGLT2i after a median of 8.8 months. In multivariate regression for hospitalization, older age (per 10 years, odds ratio [OR], 0.57; 95% confidence interval [CI], 0.56 to 0.57), lower household income (OR, 0.93; 95% CI, 0.92 to 0.95), rural residents (OR, 0.95; 95% CI, 0.93 to 0.97), and dipeptidyl peptidase-4 inhibitor (DPP-4i) users (OR, 0.82; 95% CI, 0.81 to 0.84) were associated with lesser initiation of SGLT2i in ASCVD. Additionally, female gender (OR, 0.97; 95% CI, 0.95 to 0.99) was associated with lesser initiation of SGLT2i in HF.Conclusion: The prescription rate of SGLT2i increased gradually up to 2019 but was suboptimal in patients with ASCVD or HF. After the first hospitalization for ASCVD or HF, older age, female gender, low household income, rural residents, and DPP-4i users were less likely to initiate SGLT2i.

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Section: Discussionmentioning

confidence: 99%

Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease

Baek

Yang

et al. 2022

Diabetes Metab J

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“…This additional prognostic value of lower HGS as a predictor of allcause mortality has been reported across several cohort studies from various geographical regions [51,53,[56][57][58][59][60][61][62][63][64][65][66]. Low HGS also predicts future function in care-seeking and non-care-seeking populations [67][68][69][70][71][72][73][74] as well as falls and osteoporotic fractures among older adults [75][76][77][78][79][80][81][82], with the latter likely being directly related to reported associations with physical strength, functional mobility, and bone mineral density.…”

Section: Introductionmentioning

confidence: 71%

Identifying characteristics and clinical conditions associated with hand grip strength in adults: the Baseline Health Study

Taylor

Carroll²,

Short³

et al. 2023

Preprint

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Background: Low hand grip strength (HGS) predicts several conditions, but its value outside of the older adult population is unclear. We sought to identify the most salient factors associated with HGS using a rich list of candidate variables while stratifying by age and sex. Methods: We used data from the initial visit from the Project Baseline Health Study (N=2502) which captured detailed demographic, occupational, social, lifestyle, and clinical data. We applied MI-LASSO using group methods to determine variables most associated with HGS out of 175 candidate variables. We performed analyses separately for sex and age (<65 vs. ≥65). Results: Race was associated with HGS to varying degrees across groups. Osteoporosis and osteopenia were negatively associated with HGS in female study participants. Immune cell counts were negatively associated with HGS for male participants ≥65 (neutrophils) and female participants (≥65, monocytes; <65, lymphocytes). Most findings were age and/or sex group-specific; few were common across all groups. Conclusions: Several of the variables associated with HGS in each group were novel, while others corroborate previous research. Our results support HGS as a useful indicator of a variety of clinical characteristics; however, its utility varies by age and sex.

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“…57 Moreover, several large-scale population-based cohort studies have also demonstrated the close link between poor glycemic control and fracture risks. 79,80 Although fracture and fracture-related mortality are significantly increased in DM compared to in non-DM, there are still many confounding factors modifying the risk, which included sex, age, rate, fracture sites, study design, and geographical regions. Additionally, as shown above, T1DM has a much higher risk of fracture compared to T2DM.…”

Section: Bone Health and Diabetes Mellitusmentioning

confidence: 99%

“…57 Moreover, several large-scale population-based cohort studies have also demonstrated the close link between poor glycemic control and fracture risks. 79,80…”

Section: Bone Health and Diabetes Mellitusmentioning

confidence: 99%

To do one and to get more: Part I. Diabetes and bone

Lee

Wang

Yang

et al. 2022

Journal of the Chinese Medical Association

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Type 2 diabetes mellitus (T2DM), is a chronic metabolic disease, characterized by the presence of hyperglycemia and insulin resistance. The key treatment strategies for T2DM include modification of lifestyle, medications, and continuous glucose monitoring. DM patients often have DM-associated morbidities and comorbidities; however, disorders of musculoskeletal system are often neglected, compared to other major systems in DM patients. Based on sharing similar pathophysiology of DM and osteoporosis, it is supposed that the use of antidiabetic agents (ADAs) may not only provide the lowering glucose level effect and the maintenance of the sugar homeostasis to directly delay the tissue damage secondary to hyperglycemia but also offer the benefits, such as the prevention of developing osteoporosis and fractures. Based on the current review, evidence shows the positive correlation between DM and osteoporosis or fracture, but the effectiveness of using ADA in the prevention of osteoporosis and subsequent reduction of fracture seems to be inconclusive. Although the benefits of ADA on bone health are uncertain, the potential value of "To do one and to get more" therapeutic strategy should be always persuaded. At least, one of the key treatment strategies as an establishment of healthy lifestyle may work, because it improves the status of insulin resistance and subsequently helps DM control, prevents the DM-related micro-and macrovascular injury, and possibly strengthens the general performance of musculoskeletal system. With stronger musculoskeletal system support, the risk of "fall" may be decreased, because it is associated with fracture. Although the ADA available in the market does not satisfy the policy of "To do one and to get more" yet, we are looking forward to seeing the continuously advanced technology of drug development on diabetic control, and hope to see their extra-sugar-lowering effects.

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Risk Factors for Incident Fracture in Older Adults With Type 2 Diabetes: The Framingham Heart Study

Cited by 24 publications

References 42 publications

Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease

Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease

Identifying characteristics and clinical conditions associated with hand grip strength in adults: the Baseline Health Study

To do one and to get more: Part I. Diabetes and bone

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