Do Intensive Lifestyle Changes Up Frailty Fracture Risk in Diabetes?

HealthDay News — For overweight or obese individuals with diabetes, intensive lifestyle intervention does not increase overall fracture risk but correlates with increased risk of frailty fracture, according to a study published online in the Journal of Bone and Mineral Research.

Karen C. Johnson, MD, MPH, from the University of Tennessee Health Science Center in Memphis, and colleagues examined the correlation between long-term intentional weight loss and fracture risk in overweight or obese individuals with diabetes. A total of 5145 persons aged 45 to 76 years were randomly assigned to either intensive lifestyle intervention with reduced calorie consumption and increased physical activity or diabetes support and education intervention. The authors ascertained incident fractures every 6 months.

The researchers found that over the intervention period (median: 9.6 years), weight loss was 6% and 3.5% in the intensive lifestyle intervention and diabetes support and education intervention groups, respectively. There were no between-group statistically significant differences in incident total or hip fracture rates. The intensive lifestyle intervention group had a significantly increased risk of a frailty fracture compared to the diabetes support and education intervention group (hazard ratio: 1.39).

“An intensive lifestyle intervention resulting in long-term weight loss in overweight/obese adults with diabetes was not associated with an overall increased risk of incident fracture but may be associated with an increased risk of frailty fracture,” the authors write. “When intentional weight loss is planned, consideration of bone preservation and fracture prevention is warranted.”

Disclosures: Several authors disclosed financial ties to the pharmaceutical, medical device, and nutrition industries.

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Johnson KC, Bray GA, Cheskin LJ, et al. The effect of intentional weight loss on fracture risk in persons with diabetes: results from the look AHEAD randomized clinical trial [published online July 28, 2017]. J Bone Miner Res. doi:10.1002/jmbr.3214