ArticleDiabetes care2015
Type 1 diabetes is associated with an increased risk of fracture across the life span: a population-based cohort study using The Health Improvement Network (THIN).
Article in Diabetes care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 140 papers, 10 of them syntheses that pooled it.
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Who cites it
140 citing papers in PubMed, 10 syntheses or guidelines pooled it, 268 citations in OpenAlex.
- Trabecular bone score in adults with type 1 diabetes: a meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Pooled it
- Trabecular bone score in type 1 diabetes: a meta-analysis of cross-sectional studies.Journal of orthopaedic surgery and research · 2023Pooled it
- Systematic review: associations of calcium intake, vitamin D intake, and physical activity with skeletal outcomes in people with Type 1 diabetes mellitus.Acta diabetologica · 2019Pooled it
- An update on the role of RANKL-RANK/osteoprotegerin and WNT-ß-catenin signaling pathways in pediatric diseases.World journal of pediatrics : WJP · 2019Pooled it
- Pooled it
- ISPAD Clinical Practice Consensus Guidelines 2018: Other complications and associated conditions in children and adolescents with type 1 diabetes.Pediatric diabetes · 2018Guideline
- Fracture risk in young and middle-aged adults with type 1 diabetes mellitus: A systematic review and meta-analysis.Clinical endocrinology · 2018Pooled it
- Diabetes mellitus is a risk factor for low bone mass-related fractures: A meta-analysis of cohort studies.Medicine · 2017Pooled it
- Bone mineral density at femoral neck and lumbar spine in adults with type 1 diabetes: a meta-analysis and review of the literature.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Pooled it
- Pooled it
- Altered cortical bone strength and lean mass in young women with long-duration (19 years) type 1 diabetes.Scientific reports · 2020Trial
- Pediatric osteoporosis: a comprehensive imaging-based review of diagnosis, differential diagnosis, and etiology.Skeletal radiology · 2026Review
- Exercise Alleviates Osteoporosis and Hyperglycemia in Type 1 Diabetes Mellitus Mice via Piezo1-Mediated Mechanotransduction.Biology · 2026Article
- [Diagnosis and management of diabetes and co-existing osteoporosis (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- Bone Organoids: A Novel Tool for Modeling and Managing Skeletal Disorders in Diabetes.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Contributions of Bone Microarchitecture to Skeletal Fragility in Adults with Longstanding Type 1 Diabetes.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Obesity in Type 1 Diabetes: Moving Beyond the "Lean" Disease Paradigm to Understand Risk, Complications, and Treatment.Current obesity reports · 2026Review
- Impaired Bone Density and Quality in Type 1 Diabetes Mellitus: Prevalence and Key Clinical Correlations.Journal of clinical medicine · 2026Article
- Effect of Canagliflozin Pretreatment on the Efficacy of Insulin Therapy to Rescue Type 1 Diabetes-Related Bone Fragility in Male Mice.Calcified tissue international · 2026Article
- Panx1 and P2X7R are associated with impaired skeletal health and delayed bone development in early onset of type 1 diabetes.Frontiers in endocrinology · 2026Article
80 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveThis study was conducted to determine if type 1 diabetes is associated with an increased risk of fracture across the life span. RESEARCH DESIGN AND
methodsThis population-based cohort study used data from The Health Improvement Network (THIN) in the U.K. (data from 1994 to 2012), in which 30,394 participants aged 0-89 years with type 1 diabetes were compared with 303,872 randomly selected age-, sex-, and practice-matched participants without diabetes. Cox regression analysis was used to determine hazard ratios (HRs) for incident fracture in participants with type 1 diabetes.
resultsA total of 334,266 participants, median age 34 years, were monitored for 1.9 million person-years. HR were lowest in males and females age <20 years, with HR 1.14 (95% CI 1.01-1.29) and 1.35 (95% CI 1.12-1.63), respectively. Risk was highest in men 60-69 years (HR 2.18 [95% CI 1.79-2.65]), and in women 40-49 years (HR 2.03 [95% CI 1.73-2.39]). Lower extremity fractures comprised a higher proportion of incident fractures in participants with versus those without type 1 diabetes (31.1% vs. 25.1% in males, 39.3% vs. 32% in females; P < 0.001). Secondary analyses for incident hip fractures identified the highest HR of 5.64 (95% CI 3.55-8.97) in men 60-69 years and the highest HR of 5.63 (95% CI 2.25-14.11) in women 30-39 years.
conclusionsType 1 diabetes was associated with increased risk of incident fracture that began in childhood and extended across the life span. Participants with type 1 diabetes sustained a disproportionately greater number of lower extremity fractures. These findings have important public health implications, given the increasing prevalence of type 1 diabetes and the morbidity and mortality associated with hip fractures.
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