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The following is a summary of “Application of Calcaneal Ultrasonography for Long-Term Fracture Risk Assessment in Diabetic Osteopathy,” published in the April 2025 issue of Clinical Endocrinology by Salcuni et al. 

Bone densitometry and fracture risk algorithms showed limited reliability in estimating fracture risk in individuals with diabetic osteopathy, while evidence on the role of calcaneal quantitative ultrasound (QUS) in diabetes mellitus (DM) remained scarce.  

Researchers conducted a retrospective study to determine whether calcaneal QUS effectively estimated the long-term risk of fragility fractures in individuals with diabetes mellitus (DM).  

They included 300 adults with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) who underwent calcaneal QUS assessment in 2013. Data on clinical fragility fractures, DM characteristics, and QUS parameters, including broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI), were extracted from electronic medical records. After 10 years, participants were interviewed to document fragility fractures that occurred between 2013 and 2023.  

The results showed that at baseline, 39 individuals (13%) had at least 1 fragility fracture at any site. Those with fractures had significantly lower QUS parameters than those without (P < 0.0001) in both T1DM (n = 106) and T2DM (n = 194). In 2023, 231 individuals (132 with T2DM, 99 with T1DM) completed the follow-up interview, with 31 (13%) reporting a new clinical fragility fracture and 14 (6%) experiencing a major osteoporotic fracture (MOF). Among QUS parameters, BUA was significantly associated with new MOF occurrence over 10 years in T2DM (P < 0.01) but not in T1DM.  

Investigators concluded that calcaneal QUS might have been an effective tool for evaluating fracture risk in patients with T2DM. 

Source: onlinelibrary.wiley.com/doi/10.1111/cen.15245