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Type 2 diabetes mellitus is associated with both higher bone-mineral density (BMD) and, paradoxically, higher fracture risk. Normative values for BMD, or other standardized risk assessments, such as the WHO Fracture Risk Algorithm (FRAX) score, might not perform well in diabetic patients. Data from three national prospective cohort studies were combined to assess fracture risk in 9449 older women (median follow-up, 12.6 years) and 7436 older men (median follow-up, 7.5 years). Among 770 diabetic women, 262 suffered nonspine fractures; among 1199 diabetic men, 133 suffered nonspine fractures. About one quarter of reported fractures were hip fractures.
Age- and sex-adjusted BMD (T-score) predicted fracture risk similarly for participants with o…