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In this episode of Hipcast, we explore the newly released Clinical Standards for Secondary Fracture Prevention Programs, developed by the SOS Fracture Alliance (SOSFA) and released in November 2025.

Joining us are:

• Professor Markus Seibel, Chair of the SOS Fracture Alliance and Professor of Medicine at The University of Sydney
• Dr Lauren Nacey, Geriatrician and leader in secondary fracture prevention
• Professor Rudi Jaarsma, Academic and Clinical Director of Orthopaedic Surgery at Flinders Medical Centre
• Dr Fiona Mackie, consumer representative with lived experience of osteoporosis and fracture risk

Together, they discuss why these standards were developed, the evidence and expertise that informed them, and how they aim to improve care for people who sustain a fragility fracture.

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

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Dr Grace Taylor from the Department of Orthopaedic Surgery, North Shore Hospital, Auckland, New Zealand joins to share findings from her research "Standard of care and outcomes for Māori patients with neck of femur fractures" published in the ANZ Journal of Surgery.

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In this episode of Hipcast, we speak with three clinical experts about the complexities of surgical timing in hip fracture patients who are taking SGLT2 inhibitors and GLP-1 receptor agonists.

Professor Jacqueline Close (Consultant Geriatrician, Prince of Wales Hospital / Neuroscience Research Australia), A/Prof Katherine Tonks (Endocrinologist, Sydney Endocrinology / St Vincent’s Hospital) and Dr Louisa Lowes (Anaesthetist and Director of Perioperative Medicine, Prince of Wales Hospital) share insights from their respective disciplines on balancing surgical urgency with medication-related risks.

The discussion explores:

• Mechanisms and perioperative considerations of SGLT2 inhibitors and GLP-1 agonists
• How these agents influence timing and safety of hip fracture surgery
• Interdisciplinary strategies to minimise perioperative complications
• Practical take-aways for clinicians

🔗 Resources mentioned:

• 1. Australian Diabetes Society (ADS):
     Peri-operative Management of Diabetes Medications
  2. ANZCA Safety Alert: ALERT UPDATE May 2023 Periprocedural Diabetic Ketoacidosis (DKA) with SGLT2 Inhibitor Use In People with Diabetes
  3. ANZCA Safety Alert: Clinical Practice Recommendations regarding patients taking GLP-1 receptor agonists and dual GLP-1/GIP receptor co-agonists prior to anaesthesia or sedation for surgical and endoscopic procedures.
  4. Australian and New Zealand Hip Fracture Registry (ANZHFR):
     Clinical Care Standards and Annual Report
  5. A/Prof Katherine Tonks resource: Is your patient on a SGLT-2 Inhibitor?
  6. ANZCA Patient Instructions: Preparing for your medical procedure when taking some diabetes and/or weight loss medications

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.