title: Sulfonylurea use and risk of hip fractures among elderly men and women with type 2 diabetes.
abstract: BACKGROUND
  Both increased age and type 2 diabetes mellitus are risk factors for developing bone fractures. While recent data in the elderly suggest a link between hypoglycemia and fall-related fractures, the association between sulfonylureas, commonly used hypoglycemic agents, and fracture risk has not been well investigated.
  
  
  METHODS
  We used patient data from a large commercial health insurer from 2002-2005. Individuals aged ≥65 years receiving oral sulfonylurea treatment (n=13,195) were matched 1:1 to non-users based on propensity for sulfonylurea use. Multivariable conditional logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CIs).
  
  
  RESULTS
  During an average 4 years of follow-up, sulfonylurea users experienced 226 incident hip fractures (1.7%) and non-users experienced 157 (1.2%). Sulfonylurea use was associated with increased risk of developing hip fracture (aOR 1.46, 95% CI 1.17-1.82), and this association was apparent for men (120 cases; aOR 1.83, 95% CI 1.25-2.66) and women (263 cases; aOR 1.32, 95% CI 1.03-1.69). Patients with documented hypoglycemia in the follow-up period had increased odds of hip fracture relative to those without such diagnosis (aOR 2.42, 95% CI 1.35-4.34).
  
  
  CONCLUSIONS
  Sulfonylureas are associated with increased risk of hip fracture in elderly men and women with type 2 diabetes.
authors.affiliation: Center for Observational and Real-World Evidence, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ, USA, swapnil.rajpathak@merck.com.
authors.forename: Swapnil N
authors.initials: SN
authors.lastname: Rajpathak
authors.forename: Chunmay
authors.initials: C
authors.lastname: Fu
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Brodovicz
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Engel
authors.forename: Kate
authors.initials: K
authors.lastname: Lapane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds
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