Question

Context Diabetes mellitus (DM) has been associated with an increased risk of fractures. However, the effect of glycemic control on the risk of fracture is not well understood. Objective To evaluate the association between glycemic control and the risk of low-trauma fractures in patients with type 1 DM (T1DM) and type 2 DM (T2DM). Design Nested case-control analysis. Setting UK-based Clinical Practice Research Datalink. Patients or Other Participants The study population was patients whose T1DM or T2DM had been newly diagnosed between 1995 and 2015. The cases were patients with a low-trauma fracture after DM onset. We matched four controls to each case by age, sex, general practice, fracture date, and DM type and duration. Statistical Analysis Conditional logistic regression analyses were performed, adjusted for covariates, including body mass index, smoking, DM complications and medications. Results The study population included 3329 patients with T1DM and 44,275 patients with T2DM. The median duration between DM onset and fracture date was 4.5 years for both T1DM and T2DM. The risk of fracture was increased in the patients with T1DM with a mean hemoglobin A1c >8.0% (adjusted OR, 1.39; 95% CI, 1.06 to 1.83) compared with those patients with T1DM and a mean hemoglobin A1c ≤7.0%. No such effect was found in the patients with T2DM. Independently of glycemic control, the risk of fracture was elevated in patients with T2DM and the current use of rosiglitazone and pioglitazone. Conclusions The effect of glycemic control on the risk of low-trauma fracture differs between patients with T1DM and T2DM. Poor glycemic control increased the risk of fractures in patients with T1DM but not in those with T2DM.   Based on the information from the Abstract above, please answer the following questions:

Question 3a: What is the objective of this study (2pts)?

Question 3b. What type of study design was used (2pts)?

Question 3c: What is the primary exposure of interest (2pts)?

Question 3d: What is the primary outcome of interest (2pts)?

Question 3e.i.: Is age a confounder in this study (0.5pts)?

3e.ii. Briefly explain why you gave the answer in 3.e.i. above (1.5pts)?

Answer 1

3.a.objective of this study is to evaluate the connection between glycemic control and risk of low trauma fracture in patient with type 1 and type 2 diabetes mellitus.

3.b.case control study design was used to find out the association Between sugar control and trauma in diabetes patient.

3.c.they have taken the samples of type 1 and type 2 DM from two decades(1995 to 2015) and low fracture patient who has DM and compared the control cases.

3.d.t he risk of fracture were increased in patient with type 1 DM with a mean HbA1c >8.0 ℅ compared with patient with mean HbA1C < 7.0℅.no such condition was finding patient with type 2 DM.

3.e.along with sex and types of DM and fracture type ,age is also a vital factor in this study.

3.e:2. It was an interesting study to read and understand .I feel easy to find out the answers as it is clearly mentioned every thing about the study.