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In Diabetics, Good Scores on Bone Tests May Not Rule Out Risk
Date:5/31/2011

By Steven Reinberg
HealthDay Reporter

TUESDAY, May 31 (HealthDay News) -- Although many older diabetics have good bone density scores, they are as prone to fractures as people with osteoporosis, a new study finds.

For people over 65, doctors usually recommend a bone density test to look for signs of bone loss and osteoporosis, but whether those tests are of use in older people with type 2 diabetes has been a question, according to the researchers.

"People with type 2 diabetes have a strange combination," said the study's lead researcher, Ann V. Schwartz, an associate adjunct professor in the epidemiology and biostatistics department at the University of California, San Francisco. "They have a higher fracture risk and they have a higher bone density."

However, she said, "we found that these tests work to predict fracture," though the interpretation of the results needs to be different.

To assess the value of bone density tests in predicting the risk for fractures among diabetics, the researchers looked at two tests of bone strength: bone mineral density, which produces what's called a T score, and the World Health Organization's fracture risk algorithm, called a FRAX score.

"A T score of minus 2.5 or lower is generally considered osteoporotic and at high risk of fracture," Schwartz said. "But if you have someone with type 2 diabetes who has a T score of minus 2, they have about the same fracture risk as a non-diabetic with a T score of minus 2.5," she said.

Doctors should use bone density to screen older adults with type 2 diabetes, Schwartz said, "but they have to realize that the threshold they use to indicate high risk has to be raised."

The report was published in the June 1 issue of the Journal of the American Medical Association.

For the study, Schwartz's team collected data on 9,449 women and 7,436 men who took part in one of three studies, the Study of Osteoporotic F
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