MON-795 Type 2 Diabetes and 10 Year Fracture Mortality in a South East Asian Population

Abstract Disclosure: T.F. King: None. V.S. Tan: None. J.J. Koh: None. K. Choo: None. L.U. Gani: None. INTRODUCTION: Diabetes and fragility fractures are both major global health challenges. Singapore has a high prevalence of Type 2 Diabetes (T2DM) at 10.5%, with estimates rising to 15% by 2050. It is also projected that more than 50% of all fragility fractures will occur in Asia by the year 2050. Studies have shown that patients with T2DM have a higher risk of fragility fracture, including a 40% to 70% increased fracture risk at the hip. Data on long term follow up could further our understanding of the natural history and mortality following a fracture in patients with T2DM and help plan optimal primary and secondary fracture prevention. Methods: Retrospective analysis of 10 year follow up after fragility fracture (occurring after a fall from a standing height or less). All patients admitted to the hospital with fragility fractures occurring in 2009 were assessed for baseline demographics, T2DM status and Charlson comorbidity index (CCI). Subjects were censored after 10 years, osteoporosis treatment and date of death were recorded. Risk factors for mortality were assessed using Cox proportional hazard ratio with a significance level of 5%. Results: There were 755 patients with fragility fractures at the following sites (n(%)): hip 314 (42%), vertebral 124 (16%), lower limb 83 (11%), forearm 82 (11%), pelvis 61 (8%), humerus 55 (6%), others 47 (6%). Median [IQR] age at time of initial fracture was 77.0 years [68.0, 84.0], the majority (77%) were female, median age adjusted CCI was 5.0 [4.0, 6.0]. Thirty percent (n=227) had T2DM, and age at admission was similar for those with and without T2DM. After 10 years, 160 (70%) T2DM patients died vs 293 (55%) non-T2DM patients (p<0.001), with median survival of 6.2 years vs 9.0 years in those without T2DM. There was a higher proportion of hip fractures in the T2DM group compared to the non-T2DM group (46% vs 40%, p=0.013). After adjustments, patients with T2DM had a higher risk of death (HR = 1.44, 95% CI = [1.18, 1.75], p<0.001) compared to those without T2DM. There were no differences in fracture types within the T2DM population that survived or died, but those with evidence of end organ damage had significantly higher proportion of death compared to DM2 patients without organ damage. Overall prescription of antiresorptives was low at 16%, with no difference in survival in those that received vs those that did not. CONCLUSIONS: Patients with T2DM presenting with fragility fractures had a significantly higher risk of death in the following 10 years. Amongst T2DM patients, age, comorbidities and end organ damage were significantly associated with death rather than fracture types. Future studies should further analyse strategies that can reduce mortality rate in older DM2 patients who presents with fractures with these comorbidities. Presentation: Monday, July 14, 2025