Insulin-treated Type 2 Diabetes Triples 30-Day Hospital Readmission Risk After Hip Fracture in Older Adults

The global aging population is driving up the prevalence of both Type 2 Diabetes Mellitus (T2DM) and hip fractures, two conditions that significantly contribute to morbidity, mortality, and healthcare costs in older adults. When these conditions coexist, clinical outcomes and quality of life are further compromised. Current standard care often overlooks the specific risks associated with diabetes management in the perioperative period for hip fracture patients, creating a critical gap in understanding and mitigating adverse post-discharge events, particularly early readmissions.

This observational, longitudinal study included a total of 1,164 patients aged ≥65 years who experienced a hip fracture and were treated at a public university hospital between 2017 and 2022. The primary exposure variable was the presence of Type 2 Diabetes Mellitus (T2DM), categorized by insulin treatment status. Researchers collected comprehensive sociodemographic, clinical, and surgical data. A 1-month follow-up after hospital discharge tracked key 30-day outcomes, including mortality, hospital readmission, reoperation, functional change, and change of residence, to assess the association with T2DM status.

Patients with insulin-treated diabetes demonstrated a significantly higher percentage of 30-day hospital readmission at 11.4%. This rate was substantially greater than that observed in patients without diabetes (3.3%) and those with non-insulin-treated diabetes (2.9%). Statistical analysis confirmed that insulin-treated diabetes was independently associated with a markedly increased risk of 30-day hospital readmission.

Insulin-treated diabetes was linked to a 3.36-fold increased risk of 30-day hospital readmission (hazard ratio = 3.36; 95% confidence interval 1.59-7.08). No other statistically significant differences were identified across the remaining outcomes analyzed, including mortality, reoperation, functional change, or change of residence, highlighting the specific impact on early readmission rates.