Patients with type 2 diabetes (T2D) had a lower likelihood of fractures when using insulin glargine compared to NPH insulin. 

During a period of ≥2 years, lower odds of ≥1 fracture were seen in the long-standing insulin glargine group vs. the NPH insulin group (odds ratio [OR] 0.78, 95% CI: 0.65-0.95) (insulin detemir vs. NPH insulin: OR 1.03, 95% CI: 0.79-1.36).

The results come from a new retrospective study which included data from 105,960 patients with T2D from 1,072 medical practices across Germany. Using a multivariate logistic regression model, fracture risk of the following therapies were compared: 1) incident insulin therapy vs. oral antidiabetic drugs, 2) basal-supported oral therapy vs. supplementary insulin therapy vs. conventional insulin therapy, and 3) insulin glargine vs. insulin detemir vs. NPH insulin.

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Results showed that lower odds of incident fractures were associated with oral antidiabetic treatment compared to incident insulin treatment, though the difference was not significant (OR 0.87, 95% CI: 0.72-1.06). There were higher odds for conventional insulin therapy (OR 1.59, 95% CI: 0.89-2.84) and supplementary insulin therapy (OR 1.20, 95%C CI: 0.63-2.27) compared to basal-supported oral therapy, though this difference was also deemed not significant.

Summary and Clinical Applicability

Patients with T2D had a lower likelihood of fractures by taking insulin glargine compared to taking NPH insulin. The authors of this study call for further research to be conducted which can differentiate whether reduced hypoglycemia rates are the cause behind the lower risk of having fractures.

Patients with T2D may benefit from early visual assessment, regular exercise to improve muscle strength and balance, and specific measures for preventing falls.


Pscherer S, Kostev K, Dippel FW, Rathmann W. Fracture risk in patients with type 2 diabetes under different antidiabetic treatment regimens: a retrospective database analysis in primary care. Diabetes Metab Syndr Obes. 2016;9:17-23.

This article originally appeared on MPR