Increased risk for fracture, beginning in childhood and extending through life, is associated with type 1 diabetes, according to recent study findings published in Diabetes Care. 

David R. Weber, MD, MS, of Golisano Children’s Hospital, University of Rochester School of Medicine and Dentistry, and colleagues from the Children’s Hospital of Philadelphia evaluated data from The Health Improvement Network (THIN) on 30,394 participants aged 0 to 89 years with type 1 diabetes and 303,872 randomly selected age-, sex- and practice-matched participants without diabetes (controls) to determine the effect of type 1 diabetes on the risk for fracture.


David Weber


David R. Weber



A history of fracture prior to the start of study follow-up was more common in participants with type 1 diabetes (19.6%) compared with controls (17%). Incident fractures occurred in more participants with type 1 diabetes (8.6%) compared with controls (6.1%) during the study period.

An increased risk for fracture was found for participants with type 1 diabetes in all age categories.

HRs for fracture in men ranged from 1.14 (95% CI, 1.01-1.29) in those aged less than 20 years to 2.18 (95% CI, 1.79-2.65) in those aged 60 to 69 years and women from 1.35 (95% CI, 1.12-1.63) in those aged less than 20 years to 2.03 (95% CI, 1.73-2.39) in those aged 40 to 49 years.

Lower extremity fractures comprised a greater proportion of incident fractures in participants with type 1 diabetes compared with controls (both sexes, P < .001). Hip fractures also were more common among participants with type 1 diabetes (P = .04 for men; P = .001 for women).

“There is growing evidence to suggest that type 1 diabetes results in impaired bone health and skeletal fragility,” Weber told Endocrine Today.

“Our study extends these findings, showing for the first time that type 1 diabetes is associated with an increased risk of fracture that begins in childhood and extends across the entire lifespan.

Further research is necessary to elucidate the etiology of type 1 diabetes related skeletal fragility and to develop appropriate clinical practice guidelines for the screening, prevention and treatment of this important diabetes related complication.”

Disclosure: Weber reports no relevant financial disclosures.



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