Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2015 Sep;32(9):1134-42.
doi: 10.1111/dme.12734. Epub 2015 Jun 12.

Type 1 diabetes and risk of fracture: meta-analysis and review of the literature

V N Shah  1 , C S Shah  2 , J K Snell-Bergeon  1
Affiliations
Meta-Analysis

Type 1 diabetes and risk of fracture: meta-analysis and review of the literature

V N Shah et al. Diabet Med. 2015 Sep.

Abstract

Aims: To conduct a systematic review and meta-analysis of observational studies in order to assess the association between Type 1 diabetes and fractures.

Background: The risk of fracture in men and women with Type 1 diabetes has not been studied in a large prospective well designed cohort.

Methods: Data were selected from Medline and Embase and abstracts from annual scientific meetings of various diabetes and bone and mineral societies. Published studies that reported the fracture risk in people with Type 1 diabetes in comparison with people without diabetes between 1990 and July 2014 and abstracts from various annual meeting (2005 onwards) were included in the present meta-analysis. Data were extracted from the text of included publications or from abstracts of conferences.

Results: The 14 studies that met the inclusion criteria reported 2066 fracture events among 27 300 people with Type 1 diabetes (7.6%) and 136 579 fracture events among 4 364 125 people without diabetes (3.1%). The pooled relative risk of any fracture in people with Type 1 diabetes was 3.16 (95% CI 1.51-6.63; P = 0.002). Women and men with Type 1 diabetes had a four and two times higher risk of any fractures, respectively, compared with people without diabetes. The pooled relative risks of hip fractures and spinal fractures were 3.78 (95% CI 2.05-6.98; P < 0.001) and 2.88 (95% CI 1.71-4.82; P < 0.001), respectively, among people with Type 1 diabetes.

Conclusions: Our meta-analysis suggests that both men and women with Type 1 diabetes might have an increased risk of any fractures. A large prospective epidemiological study is needed to confirm our findings.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1
Flow of study selection and search
Figure 2
Figure 2
Forest plot for fracture risk in subjects with type 1 diabetes
See this image and copyright information in PMC

References

    1. Leslie WD, Morin SN. Osteoporosis epidemiology 2013: implications for diagnosis, risk assessment, and treatment. Curr Opin Rheumatol. 2014;26:440–446. - PubMed
    1. Hiligsmann M, Kanis JA, Compston J, et al. Health technology assessment in osteoporosis. Calcif Tissue Int. 2013;93:1–14. - PMC - PubMed
    1. Siris ES, Miller PD, Barrett-Connor E, et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA. 2001;286:2815–2822. - PubMed
    1. Krakauer JC, McKenna MJ, Buderer NF, Rao DS, Whitehouse FW, Parfitt AM. Bone loss and bone turnover in diabetes. Diabetes. 1995;44:775–782. - PubMed
    1. Heilman K, Zilmer M, Zilmer K, Tillmann V. Lower bone mineral density in children with type 1 diabetes is associated with poor glycemic control and higher serum ICAM-1 and urinary isoprostane levels. J Bone Miner Metab. 2009;27:598–604. - PubMed