Race and ethnicity influence fracture risk in diabetic patients

Caucasians and Hispanics with diabetes have a greater risk of fracture compared to those without diabetes, while African Americans with diabetes have little to no additional fracture risk, according to a study to be presented Saturday, March 23 at ENDO 2019, the Endocrine Society's annual meeting in New Orleans, La.

"Diabetes has been associated with additional risk of fracture, but it had not been well studied in African Americans or Hispanics, the two racial-ethnic groups with the highest rates of diabetes in the United States," said lead researcher Rajesh Jain, M.D., of the Lewis Katz School of Medicine at Temple University in Philadelphia, Pa.

He noted that because of the additional fracture risk associated with diabetes, some medical groups have suggested additional osteoporosis screening or treatment to help prevent fractures in patients with diabetes. "This research could mean that African Americans with diabetes may not require the additional screening or treatment for osteoporosis that Caucasians or Hispanics with diabetes may require," Jain said.

The researchers evaluated data from 19,153 people with diabetes (7,618 Caucasian, 7,456 African American and 4,079 Hispanic) and 26,217 people with hypertension (15,138 Caucasian, 8,301 African American, and 2,778 Hispanic), all at least 40 years of age.

When controlling for other important factors, the risk of fracture in white and Hispanic people with diabetes was 23 percent higher than those without diabetes. However, the risk of fracture in African Americans with diabetes was not significantly different than those without diabetes.

"This is a novel finding and has not been previously reported," Jain said.

African Americans, regardless of whether they had diabetes, had more than 10-fold risk of a fracture if they had a fracture in the past, compared with about a two-fold increased risk in white and Hispanic people.

"This suggests risk factors for fracture may differ in African Americans," Jain said.

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