Fracture risk tools may require tailoring for patients with diabetes

EXPERTS are divided over whether fracture risk assessment tools should now be adjusted, after a study showed they underestimated fracture risk in people with type 2 diabetes.

US researchers used data from three prospective studies of more than 16,000 patients to show that femoral neck bone mineral density (BMD) T score and WHO fracture risk algorithm (FRAX) score predicted fracture risk in older type 2 diabetes patients.

Patients with type 2 diabetes had a higher BMD, but for a given T score they had a higher risk of hip or non-spine fracture when compared with those without type 2 diabetes of a similar age.

Therefore, a woman with type 2 diabetes with a T score of -1.9 would have an estimated 10-year hip fracture risk similar to a woman without type 2 diabetes with a T score of -2.5. More frequent falls in older adults with type 2 diabetes could increase fracture risk for a given BMD.

Professor Rebecca Mason, deputy director of the Bosch