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Elevated fracture risk in a Danish cohort with type 2 diabetes mellitus and microvascular diseases

Mohamad I Nasser1,2,3, Therese K Grønborg4,5, Frederik P B Kristensen4,5

  • 1Department of Endocrinology and Metabolism, Molecular Endocrinology Laboratory (KMEB), Odense University Hospital, Odense, 5230, Denmark.

JBMR Plus
|August 19, 2026
PubMed
Abstract

Insights

Microvascular diseases (MVD) in type 2 diabetes mellitus (T2D) increase fracture risk. Neuropathy, a type of MVD, showed the highest fracture risk in T2D patients.

Area of Science:

  • Endocrinology
  • Diabetology
  • Bone Health

Background:

  • Microvascular diseases (MVD) in type 2 diabetes mellitus (T2D) are linked to bone microarchitecture changes.
  • The association between MVD and fracture risk in T2D patients remains unclear.

Purpose of the Study:

  • To investigate if MVD, including retinopathy, nephropathy, and neuropathy, is associated with an increased risk of fractures in individuals with T2D.

Main Methods:

  • A cohort of 10,491 individuals with T2D was analyzed between 2010 and 2022.
  • Fracture outcomes (any fracture and major osteoporotic fractures) were compared between individuals with and without hospital-diagnosed MVD.
  • Cox proportional hazard models were used to calculate hazard ratios.

Main Results:

  • Individuals with T2D and MVD had a higher rate of any fracture (aHR 1.31) and major osteoporotic fractures (aHR 1.33) compared to those without MVD.
  • Neuropathy was associated with the highest risk for both any fracture (aHR 1.49) and major osteoporotic fractures (aHR 1.54).

Conclusions:

  • Fracture risk is elevated in individuals with type 2 diabetes mellitus complicated by microvascular diseases.
  • Neuropathy is a significant risk factor for fractures in this patient population.
Keywords:
fracturesmicrovascular diseasesnephropathyneuropathyretinopathytype 2 diabetes mellitus

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