Diabetes Affects Bones in the Elderly

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Type 2 diabetes mellitus in nursing home patients: effects on bone turnover, bone mass, and fracture risk, by H. Dobnig and colleagues. J Clin Endocrinol Metab 91:3355–3363, 2006.

What is the problem and what is known about it so far?

Research suggests that type 2 diabetes affects the growth and strength of bone. While some studies find no change or a decrease in bone mass, many other studies find that bone mass actually increases in people with diabetes and is less likely to fracture.

On the other hand, elderly people with diabetes are more likely to fall because of vision and nerve damage resulting from diabetes. Since fractures are a common and serious problem among elderly people, more information is needed to understand the problem.

Why did the researchers do this particular study?

The researchers wanted to study the effect of diabetes on bone mass and growth, and the likelihood of bone fractures, on frail elderly women in nursing homes.

Who was studied?

The study included 583 people with diabetes and 1,081 people without diabetes, all more than 70 years of age, who lived in 95 nursing homes in Austria.

How was the study done?

Participants had a physical exam and blood drawn for lab tests to assess diabetes. Ultrasound was used to assess bone density and growth, and other tests measured muscle strength.

Participants were followed for two years. During this time, researchers kept track of hip fractures and deaths.

What did the researchers find?

People with diabetes had greater bone mass, but still had the same likelihood of hip fracture as people without diabetes.

What were the limitations of the study?

All participants were nursing home residents, and the results may be different for more active and independent elders who live at home. Not all participants had blood tests. A small number of people presumed to be healthy had or developed diabetes, but the researchers don’t think this affected the study’s results.

What are the implications of the study?

Diabetes increases bone density and may protect against fractures, but frail elderly women in nursing homes still are vulnerable to hip fractures.

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