Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Sep;91(9):3355-63.
doi: 10.1210/jc.2006-0460. Epub 2006 May 30.

Type 2 diabetes mellitus in nursing home patients: effects on bone turnover, bone mass, and fracture risk

Harald Dobnig  1 , Jutta Claudia Piswanger-Sölkner, Martin Roth, Barbara Obermayer-Pietsch, Andreas Tiran, Andrea Strele, Elisabeth Maier, Peter Maritschnegg, Christian Sieberer, Astrid Fahrleitner-Pammer
Affiliations

Type 2 diabetes mellitus in nursing home patients: effects on bone turnover, bone mass, and fracture risk

Harald Dobnig et al. J Clin Endocrinol Metab. 2006 Sep.

Abstract

Context: Fractures are a major health burden in elderly institutionalized persons. Type 2 diabetes mellitus (DM) has a high prevalence in nursing home patients and has been associated with positive effects on bone mass in younger, community-dwelling elderly.

Objective: The objective of this study was to investigate whether type 2 DM affects bone mass, bone turnover, or prospective fracture rates in frail, elderly women living in nursing homes.

Design, setting, and participants: This study was a prospective cohort of 583 patients with type 2 DM and 1081 control (CTR) individuals above age 70 recruited from 95 nursing homes in Austria. Patients were enrolled and followed up by mobile study teams.

Main outcome measures: We performed quantitative bone ultrasound measurements at the calcaneus, radius, and proximal third phalanx, measurements of quadriceps strength, and biochemical parameters of mineral metabolism and bone turnover. Patients were prospectively followed for hip and other nonvertebral fractures over 2 yr.

Results: Patients with type 2 DM had significantly higher age-, weight-, and mobility score-adjusted calcaneal stiffness (P < 0.0001), radial speed of sound (P < 0.005), and phalangeal speed of sound (P < 0.05) measurements when compared with CTRs. Mean serum PTH (-20.7%) and osteocalcin levels (-22.3%) were significantly lower (both P < 0.0001) in patients with treated type 2 DM despite comparable low serum 25-hydroxyvitamin D levels and slightly higher adjusted total serum calcium levels compared with CTRs. Important independent determinants of bone turnover in both patient groups were PTH, creatinine clearance, alanine aminotransferase, as well as glycosylated hemoglobin levels, together accounting for 30-40% of its variance. A total of 110 hip fractures occurred during the observation period, corresponding to a hip fracture rate of 3.1% (in CTRs) and 3.4% (in type 2 DM) per 100 patient years; this was not significantly different for CTRs and diabetics.

Conclusions: Decreased PTH levels and higher levels of glycemia independently contribute to lower bone turnover in elderly nursing home patients with type 2 DM. Despite higher bone mass and lower bone turnover, hip fracture risk is comparable with women without DM.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

  • Type 2 diabetes and risk of low-energy fractures in postmenopausal women: meta-analysis of observational studies.
    Dytfeld J, Michalak M. Dytfeld J, et al. Aging Clin Exp Res. 2017 Apr;29(2):301-309. doi: 10.1007/s40520-016-0562-1. Epub 2016 Apr 12. Aging Clin Exp Res. 2017. PMID: 27072353 Free PMC article.
  • Diabetes mellitus and risk of hip fractures: a meta-analysis.
    Fan Y, Wei F, Lang Y, Liu Y. Fan Y, et al. Osteoporos Int. 2016 Jan;27(1):219-28. doi: 10.1007/s00198-015-3279-7. Epub 2015 Aug 12. Osteoporos Int. 2016. PMID: 26264604
  • Common Dietary Modifications in Preclinical Models to Study Skeletal Health.
    Rendina-Ruedy E, Smith BJ. Rendina-Ruedy E, et al. Front Endocrinol (Lausanne). 2022 Jul 14;13:932343. doi: 10.3389/fendo.2022.932343. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 35909523 Free PMC article. Review.
  • Update of the fracture risk prediction tool FRAX: a systematic review of potential cohorts and analysis plan.
    Vandenput L, Johansson H, McCloskey EV, Liu E, Åkesson KE, Anderson FA, Azagra R, Bager CL, Beaudart C, Bischoff-Ferrari HA, Biver E, Bruyère O, Cauley JA, Center JR, Chapurlat R, Christiansen C, Cooper C, Crandall CJ, Cummings SR, da Silva JAP, Dawson-Hughes B, Diez-Perez A, Dufour AB, Eisman JA, Elders PJM, Ferrari S, Fujita Y, Fujiwara S, Glüer CC, Goldshtein I, Goltzman D, Gudnason V, Hall J, Hans D, Hoff M, Hollick RJ, Huisman M, Iki M, Ish-Shalom S, Jones G, Karlsson MK, Khosla S, Kiel DP, Koh WP, Koromani F, Kotowicz MA, Kröger H, Kwok T, Lamy O, Langhammer A, Larijani B, Lippuner K, Mellström D, Merlijn T, Nordström A, Nordström P, O'Neill TW, Obermayer-Pietsch B, Ohlsson C, Orwoll ES, Pasco JA, Rivadeneira F, Schei B, Schott AM, Shiroma EJ, Siggeirsdottir K, Simonsick EM, Sornay-Rendu E, Sund R, Swart KMA, Szulc P, Tamaki J, Torgerson DJ, van Schoor NM, van Staa TP, Vila J, Wareham NJ, Wright NC, Yoshimura N, Zillikens MC, Zwart M, Harvey NC, Lorentzon M, Leslie WD, Kanis JA. Vandenput L, et al. Osteoporos Int. 2022 Oct;33(10):2103-2136. doi: 10.1007/s00198-022-06435-6. Epub 2022 May 31. Osteoporos Int. 2022. PMID: 35639106 Review.
  • Bone structure and turnover in type 2 diabetes mellitus.
    Shu A, Yin MT, Stein E, Cremers S, Dworakowski E, Ives R, Rubin MR. Shu A, et al. Osteoporos Int. 2012 Feb;23(2):635-41. doi: 10.1007/s00198-011-1595-0. Epub 2011 Mar 19. Osteoporos Int. 2012. PMID: 21424265 Free PMC article.
See all "Cited by" articles

Publication types

MeSH terms