Although long-term glucose fluctuation has been linked to an increased risk of osteoporosis, there have been no prior investigations investigating the association between glucose variability and fractures in persons who do not have diabetes. Researchers looked and examined fasting plasma glucose (FPG) changes from visit to visit as a predictive factor in predicting osteoporotic fractures in people who didn’t have diabetes. They investigated the effect of FPG on the development of osteoporotic fractures in men and women using a statewide cohort database. The number of total fractures and vertebral fractures were the key outcomes. FPG variability was calculated using the standard deviation (FPG-SD), coefficient of variation (FPG-CV), and variability independent of the mean (VIM) (FPG-VIM). During a mean follow-up of 8.4 years, 5262 of the 92 929 individuals suffered osteoporotic fractures. After adjusting for mean FPG and other risk variables, those in the highest quartile of FPG-SD had an 11 per cent and 16 per cent increase in the risk of total and vertebral fractures, respectively, compared to those in the lowest quartile. Analyses utilising FPG-CV and FPG-VIM yielded comparable findings. Subgroup and sensitivity studies to investigate potential heterogeneity yielded consistent results. 

FPG variability may represent a unique risk factor for osteoporotic fractures that is independent of risk variables in the general population who do not have diabetes.