Association between Type 2 Diabetes and 30-Day Clinical Outcomes following Hospital Discharge for Hip Fracture in Older Adults

Abstract

Background Population aging is increasing the prevalence of type 2 diabetes mellitus (T2DM) and hip fractures, which are major contributors to morbidity, mortality, and healthcare costs among older adults. The coexistence of both conditions further worsens clinical outcomes and quality of life. This study analyzes the association between T2DM and 30-day outcomes after hip fracture. Methods Observational, longitudinal study with a 1-month follow-up after hospital discharge, including a total of 1,164 patients aged ≥65 years with hip fracture treated at a public university hospital between 2017 and 2022. The main variable was the presence of T2DM. Sociodemographic, clinical, and surgical variables, along with 30-day outcomes (mortality, readmission, reoperation, functional change, and change of residence), were collected. Results Patients with insulin-treated diabetes showed a higher percentage of 30-day hospital readmission (11.4%) compared with patients without diabetes (3.3%) and those with non–insulin-treated diabetes (2.9%). Insulin-treated diabetes was associated with an increased risk of 30-day hospital readmission (hazard ratio=3.36; 95% confidence interval 1.59–7.08). No statistically significant differences were observed in the remaining outcomes analyzed. Conclusion Individuals with insulin-treated diabetes exhibit an increased risk of hospital readmission following hip fracture. These findings highlight the need for targeted perioperative management, closer post-discharge monitoring, and diabetes-specific care pathways for this high-risk subgroup. Implementing individualized follow-up and optimizing glycemic control may help reduce early readmissions and improve short-term clinical outcomes in patients with type 2 diabetes, particularly those treated with insulin.