Association of BMD and FRAX Score With Risk of Fracture in Older Adults With Type 2 Diabetes

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Abstract
Prevention of fractures is an important goal in older adults. It is increasingly recognized that adults with type 2 diabetes mellitus (DM), an estimated 17% of older adults in the United States,1 have a higher fracture rate.2-6 Preventive identification of adults at higher fracture risk is based on bone mineral density (BMD) T scores, used alone or in the World Health Organization (WHO) Fracture Risk Algorithm (FRAX) score.7 However, because type 2 DM is paradoxically associated with higher BMD and increased fracture risk,2 there is concern that these established methods for predicting fractures may not perform adequately in patients with type 2 DM.8,9 There is a need to clarify the use of standard methods for assessing fracture risk in this expanding population of older adults.