Elderly people with diabetes show an increased risk of breaking a hip, Canadian researchers have found.

For the study in the April issue of the journal Diabetes Care, investigators tracked more than 197,000 residents of Ontario with diabetes who were 66 or older to see how many were admitted to hospital for a first hip fracture.

Diabetes increased the risk of hip fracture by about 20 per cent in both men and women, compared with the hip fracture rates of Ontarians the same age without diabetes.

"With the dramatic rise in the prevalence of diabetes in Ontario, and given the fact that rates are expected to continue to increase with the with the current obesity epidemic, even a small increase in hip fracture risk among persons with diabetes will have a substantial public health impact," said the study's lead author, endocrinologist Dr. Lorraine Lipscombe of the Institute for Clinical Evaluative Studies in Toronto.

The prevalence of diabetes has increased nearly 70 per cent in Ontario in the last decade.

Environment a factor

The study showed people with diabetes were more likely to live in poorer neighbourhoods and be prescribed at least one drug that increased the likelihood of falls or decreased bone mineral density, which is linked to osteoporosis or thinning of bone.

Deaths and illness after hip fractures may also be worse in people with diabetes because they have higher rates of other illnesses and disability, Lipscombe said.

Better prevention strategies are needed for seniors with diabetes, who should be assessed for their fracture risk, the researchers recommended.

Until more is understood about how diabetes contributes to fractures, the researchers recommended better prevention strategies and fracture risk assessments for seniors with diabetes.

The study was unable to distinguish between Type 1 and Type 2 diabetes, but it is estimated more than 90 per cent of diabetes cases in this age group are Type 2.

In Type 2, weight gain, poor nutrition and lack of exercise reduce the body's ability to use insulin to control levels of sugar. Type 1 diabetes occurs when the body makes little or no insulin, and is normally treated through insulin injections.

A March 2007 study found that one in 11 adults (8.8  per cent) in Ontario — and probably the rest of Canada — are diabetic. That's up from one in 19 (5.2 per cent) in 1995.