Introduction & Objective: Patients with type 2 diabetes (T2D) have an increased risk of sustaining a fracture, and risks of nonunion, impaired fracture healing, and post-fracture complications are higher in T2D. It is largely unknown how T2D affects the cost of fractures. This study aims to estimate the cost of fractures in T2D compared to persons without diabetes, and secondly to analyze potential drivers of fracture costs. We hypothesized that cost of fractures in patients with T2D are higher than in the nondiabetic background population.

Methods: This study analyses patients in Denmark aged 18+ with a hip, humerus, forearm, foot, or ankle fracture in the period 2011-2015. Persons with polycystic ovary syndrome (PCOS), with other types of diabetes, with T2D diagnosed after fracture, and persons emigrating within the follow-up period were excluded. Patients with T2D were matched with patients without diabetes based on fracture site, sex, age, and Charlson Comorbidity Index (CCI) Score. The direct healthcare costs of fractures for T2D and controls were estimated within the first year after a fracture, and the medians were tested using Mann-Whitney U-test.

Results: In this study 5890, 3921, 5174, 2592, and 2229 cases of hip, humerus, forearm, foot, and ankle fractures, respectively, were matched 1:1 with persons without diabetes. More females than males sustained fractures with the highest prevalence (71.8%) for hip fractures and the lowest prevalence (56.7%) for foot fractures. The median age was highest for hip fractures (80 years) and lowest for foot fractures (62 years). The direct healthcare cost within one year after fracture was higher among patients with T2D compared to controls for hip (€10,733 vs. €10,585, p=0.014), humerus (€1,389 vs. €1,138, p<0.0001), forearm (€951 vs. €947, p=0.022), foot (€565 vs. €443, p<0.0001), and ankle fractures (€1,968 vs. €1,063, p<0.0001).

Conclusion: The direct healthcare costs of fractures were higher for T2D.

Disclosure

A.V. Kvist: None. M. Frost: Research Support; Novo Nordisk A/S. Stock/Shareholder; Novo Nordisk A/S. A.M. Burden: None. P. Vestergaard: None. T. Kristrensen: None.

Funding

European Union’s Horizon 2020 research and innovation program under the H2020 Marie Skłodowska-Curie Actions grant 860898.

© 2024 by the American Diabetes Association
2024
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