The Risk of Fractures in Patients with Type 1 Diabetes Mellitus

Background: A variety of complications are inherent to type 1 diabetes mellitus, and some studies have shown an increased risk of fractures among patients with diabetes. Nevertheless, much about this phenomenon remains uncertain. Our aim is to determine if there is an increased risk of fractures among these patients compared to individuals without diabetes and to investigate the potential risk factors. Methods: This study was a population-based prospective observational study. Participants were included from 2010-2013 and all participants filled out a survey regarding risk factors. In 2022, approximately 10 years after inclusion, we gathered information about fracture events over this period. Cox regression was performed to determine whether there is an increased risk of fracture among type 1 diabetes patients, and risk factors for the complication were evaluated using the same statistical method. Results: An increased risk of fractures among type 1 diabetes patients compared to controls (HR 1.655, Cl 1.193-2.297, p = 0.003) was established. Women with type 1 diabetes had an increased risk compared to women without (HR 1.953, Cl 1.269-3.005, p = 0.002), whereas no significant differences were identified for men. Older age was a risk factor for both men and women with type 1 diabetes, as was diabetes duration for women. A higher Health Assessment Questionnaire (HAQ) score was associated with a greater fracture risk in both male and female patients with type 1 diabetes, as well as in male controls. Conclusions: Women with type 1 diabetes have a twofold greater risk of fractures compared to women without diabetes. Older age, higher HAQ score, and diabetes duration were identified as risk factors.