SAT-792 A Review of Bone Health in Males with Diabetes at a VA Hospital Diabetes Clinic

Abstract Disclosure: G. Arora: None. B. Rafla: None. A. Ramachandran: None. T. Aggarwal: None. J.N. Johnson: None. S. Rupani: None. L. Graeff-Armas: None. Introduction:Diabetes Mellitus (DM), both type 1 and 2, is associated with an increased risk of fracture. For the general population, AACE 2020 guidelines recommend dexa at the age of 70 years for men. To capture the increased fracture risk that diabetes imparts, the AACE recommends using rheumatoid arthritis as a surrogate marker in the FRAX score calculation algorithm. Purpose: To determine if appropriate osteoporosis screening is being undertaken at the Diabetes Specialty Clinic at Nebraska-Western Iowa VA Healthcare system (NWIHCS -Omaha). Long-term objective is to assess for gaps, propose solutions and implement an osteoporosis screening protocol. Methodology: A retrospective chart review was conducted for Veterans seen at the Diabetes Specialty Clinic from July 1, 2018- June 31, 2023. Inclusion Criteria: male, age > 70 years, history of type 1 or 2 DM. Data collected: age, race, height, weight, smoking history, steroid use history, vitamin D status, fracture history, documentation of osteoporosis, and completion of dexa. Results: 285 charts were reviewed that met AACE criteria for dexa (male > 70 years). Median Age: 75 years. Race: 4 American-Indian, 20 African American, 259 Caucasian and 2 declined to identify. Median Height: 178 cm. Median Weight: 99 Kg. Median BMI: 32. Smoking History: Never 197 (69%), Current 35 (12%), Prior 50 (18%), Unknown 3 (1%). Steroids use > Prednisone 5 mg for >3 months was noted in 10 (0.04%). 25 OH Vitamin D: 241 (84%) had it checked and of those, median level was 39 ng/mL, 50 (18%) were <30 ng/mL and 4 (1%) were undetectable. 30 (11%) had a fragility fracture recorded and of those, 6 (20%) had osteoporosis listed on their problem list, thus 80% were missing the diagnosis and 13(43%) had a DEXA scan completed. Of the whole cohort, 54 (19%) had a dexa completed. 48 (17%) had died by the time of chart review. Conclusion: Less than a quarter i.e. only 19% of Veterans in the study received appropriate osteoporosis screening. This study is of importance because it highlights the need for devising and implementing quality improvement measures to carry out appropriate screening for osteoporosis in male patients with diabetes. Noteworthily, since the inception of this chart review, the ADA has added dexa to the list of recommended screenings for all patients with diabetes, recommending it be done by the 5 years post-diagnosis mark, which would make the pool of eligible patients much larger than what we captured in this review. Presentation: Saturday, July 12, 2025