Mixed
Intentional long-term weight loss in overweight or obese adults with type 2 diabetes increases the risk of frailty fractures (hip, pelvis, upper arm/shoulder) despite not increasing total or hip fracture rates overall.
If you have type 2 diabetes and are planning to lose weight, be aware that this specific intervention (intensive lifestyle change) has been linked to a higher risk of breaking bones in the hip, pelvis, or shoulder area, even if your overall fracture risk doesn't change. To mitigate this, focus on preserving muscle mass through resistance training and ensure adequate calcium and vitamin D intake, as bone loss is a key mechanism for this increased risk.
An intensive lifestyle intervention resulting in long term weight loss in overweight / obese adults with DM was not associated with an overall increased risk of incident fracture but may be associated with an increased risk of frailty fracture.
Why this rating
Large multicenter randomized clinical trial (Look AHEAD) with 11.3 years median follow-up and central adjudication.
Source
The Effect of Intentional Weight Loss on Fracture Risk in Persons With Diabetes: Results From the Look AHEAD Randomized Clinical Trial
Karen Johnson et al. · Journal of Bone and Mineral Research · 2017
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