Association of use of first intensification of treatment (ever-use) per glycated hemoglobin level and risk of fracture
| Treatment . | Last HbA1c value before fracture, % . | T2DM patients with fractures, n (%) . | T2DM patients without fractures, n (%) . | Unadjusted, OR (95% CI) . | Adjusteda, OR (95% CI) . |
|---|---|---|---|---|---|
| Nonexposed | No antidiabetic drug | 2324 (26.4) | 9462 (26.9) | 1.05 (0.96-1.15) | 1.04 (0.95-1.14) |
| First intensificationb | ≤ 6.5 | 469 (5.3) | 1562 (4.4) | 1.29 (1.14-1.45) | 1.28 (1.13-1.44) |
| > 6.5-7.5 | 639 (7.3) | 2736 (7.8) | 1 (Reference) | 1 (Reference) | |
| > 7.5-8.5 | 316 (3.6) | 1309 (3.7) | 1.04 (0.90-1.18) | 1.03 (0.90-1.19) | |
| > 8.5 | 267 (3.0) | 1137 (3.2) | 1.00 (0.87-1.16) | 1.01 (0.87-1.17) | |
| No recorded HbA1c level | 30 (0.3) | 108 (0.3) | 1.18 (0.81-1.73) | 1.15 (0.79-1.67) | |
| Other exposure | Other antidiabetic drugs | 4764 (54.1) | 18 905 (53.7) | 1.08 (0.99-1.17) | 1.07 (0.98-1.16) |
| Treatment . | Last HbA1c value before fracture, % . | T2DM patients with fractures, n (%) . | T2DM patients without fractures, n (%) . | Unadjusted, OR (95% CI) . | Adjusteda, OR (95% CI) . |
|---|---|---|---|---|---|
| Nonexposed | No antidiabetic drug | 2324 (26.4) | 9462 (26.9) | 1.05 (0.96-1.15) | 1.04 (0.95-1.14) |
| First intensificationb | ≤ 6.5 | 469 (5.3) | 1562 (4.4) | 1.29 (1.14-1.45) | 1.28 (1.13-1.44) |
| > 6.5-7.5 | 639 (7.3) | 2736 (7.8) | 1 (Reference) | 1 (Reference) | |
| > 7.5-8.5 | 316 (3.6) | 1309 (3.7) | 1.04 (0.90-1.18) | 1.03 (0.90-1.19) | |
| > 8.5 | 267 (3.0) | 1137 (3.2) | 1.00 (0.87-1.16) | 1.01 (0.87-1.17) | |
| No recorded HbA1c level | 30 (0.3) | 108 (0.3) | 1.18 (0.81-1.73) | 1.15 (0.79-1.67) | |
| Other exposure | Other antidiabetic drugs | 4764 (54.1) | 18 905 (53.7) | 1.08 (0.99-1.17) | 1.07 (0.98-1.16) |
Abbreviations: HbA1c, glycated hemoglobin; OR, odds ratio; T2DM, type 2 diabetes mellitus.
aAdjusted for body mass index, smoking, previous fractures (after age 18 years), previous falls, and use of bisphosphonates.
bFirst intensification of drug treatment is defined by use of metformin plus either dipeptidyl peptidase-4 inhibitors, glitazones, or sulfonylureas (according to the National Institute for Health and Care Excellence).
Association of use of first intensification of treatment (ever-use) per glycated hemoglobin level and risk of fracture
| Treatment . | Last HbA1c value before fracture, % . | T2DM patients with fractures, n (%) . | T2DM patients without fractures, n (%) . | Unadjusted, OR (95% CI) . | Adjusteda, OR (95% CI) . |
|---|---|---|---|---|---|
| Nonexposed | No antidiabetic drug | 2324 (26.4) | 9462 (26.9) | 1.05 (0.96-1.15) | 1.04 (0.95-1.14) |
| First intensificationb | ≤ 6.5 | 469 (5.3) | 1562 (4.4) | 1.29 (1.14-1.45) | 1.28 (1.13-1.44) |
| > 6.5-7.5 | 639 (7.3) | 2736 (7.8) | 1 (Reference) | 1 (Reference) | |
| > 7.5-8.5 | 316 (3.6) | 1309 (3.7) | 1.04 (0.90-1.18) | 1.03 (0.90-1.19) | |
| > 8.5 | 267 (3.0) | 1137 (3.2) | 1.00 (0.87-1.16) | 1.01 (0.87-1.17) | |
| No recorded HbA1c level | 30 (0.3) | 108 (0.3) | 1.18 (0.81-1.73) | 1.15 (0.79-1.67) | |
| Other exposure | Other antidiabetic drugs | 4764 (54.1) | 18 905 (53.7) | 1.08 (0.99-1.17) | 1.07 (0.98-1.16) |
| Treatment . | Last HbA1c value before fracture, % . | T2DM patients with fractures, n (%) . | T2DM patients without fractures, n (%) . | Unadjusted, OR (95% CI) . | Adjusteda, OR (95% CI) . |
|---|---|---|---|---|---|
| Nonexposed | No antidiabetic drug | 2324 (26.4) | 9462 (26.9) | 1.05 (0.96-1.15) | 1.04 (0.95-1.14) |
| First intensificationb | ≤ 6.5 | 469 (5.3) | 1562 (4.4) | 1.29 (1.14-1.45) | 1.28 (1.13-1.44) |
| > 6.5-7.5 | 639 (7.3) | 2736 (7.8) | 1 (Reference) | 1 (Reference) | |
| > 7.5-8.5 | 316 (3.6) | 1309 (3.7) | 1.04 (0.90-1.18) | 1.03 (0.90-1.19) | |
| > 8.5 | 267 (3.0) | 1137 (3.2) | 1.00 (0.87-1.16) | 1.01 (0.87-1.17) | |
| No recorded HbA1c level | 30 (0.3) | 108 (0.3) | 1.18 (0.81-1.73) | 1.15 (0.79-1.67) | |
| Other exposure | Other antidiabetic drugs | 4764 (54.1) | 18 905 (53.7) | 1.08 (0.99-1.17) | 1.07 (0.98-1.16) |
Abbreviations: HbA1c, glycated hemoglobin; OR, odds ratio; T2DM, type 2 diabetes mellitus.
aAdjusted for body mass index, smoking, previous fractures (after age 18 years), previous falls, and use of bisphosphonates.
bFirst intensification of drug treatment is defined by use of metformin plus either dipeptidyl peptidase-4 inhibitors, glitazones, or sulfonylureas (according to the National Institute for Health and Care Excellence).
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