An intensive lifestyle intervention resulting in long-term weight loss in overweight/obese adults with type 2 diabetes mellitus (DM) was not associated with an overall increased risk of incident fracture but may be associated with an increased risk of frailty fracture, according to a recent study. Researchers conducted a multicenter, randomized clinical trial in order to evaluate whether long-term intentional weight loss would increase fracture risk in overweight or obese persons with DM. 5,145 persons aged 45 to 76 years with DM (60% women, 63% white, mean BMI of 36 kg/m²) were randomized to either an intensive lifestyle intervention (ILI) or to diabetes support and education intervention (DSE). They found:

• Weight loss over the intervention period (median 9.6 years) was 6.0% in ILI and 3.5% in DSE.
• A total of 731 participants had a confirmed incident fracture (358 in DSE vs 373 in ILI).
• There were no statistically significant differences in incident total or hip fracture rates between the ILI and DSE groups.
• However, compared to the DSE group, the ILI group had a statistically significant 39% increased risk of a frailty fracture.