Abstract
BACKGROUND: Diabetes and osteoporosis are frequent long-term conditions. There is little information on the relationship between diabetes and the risk of refracture in people who have osteoporotic fractures (OPFs), even though both conditions have been individually associated with increased fracture risk. METHODS: We conducted a retrospective cohort study using the Osteoporotic Fracture Registry System of the Affiliated Kunshan Hospital of Jiangsu University. The study included 2,255 patients aged 50 years or older who were admitted with OPFs, comprising 107 with diabetes and 2,148 without. The risk of refracture within 1, 3, and 5 years was evaluated using Cox proportional hazard regression models based on whether or not a diabetes diagnosis was made during the admission assessment. Furthermore, the rates of refracture between individuals with and without diabetes were compared using Kaplan-Meier curves. RESULTS: In patients with OPFs, diabetes was significantly positively correlated with refracture risk. For the follow-up periods of 1, 3, and 5 years, the hazard ratios (HRs) in the fully adjusted model were 2.83 (95% confidence interval [CI]: 1.09 to 7.39, P-value = 0.033), 2.65 (95% CI: 1.27 to 5.52, P-value = 0.009), and 2.72 (95% CI: 1.39 to 5.32, P-value = 0.004), respectively. CONCLUSIONS: The findings highlight the importance of monitoring bone health and implementing preventative interventions in individuals with diabetes, since they reveal that diabetic patients face a risk of refracture that is more than twice as high as that of non-diabetic individuals.