The pattern of incident fractures according to fracture site in people with T1D

Abstract

Summary: Higher incidences of fractures are seen in people with type 1 diabetes (T1D), but knowledge on different fracture sites is sparse. We found a higher incidence mainly for distal fracture sites in people with T1D compared to controls. It must be further studied which fractures attributed to the higher incidence rates (IRs) at specific sites. Introduction: People with T1D have a higher incidence of fractures compared to the general population. However, sparse knowledge exists on the incidence rates of individual fracture sites. Therefore, we examined the incidence of various fracture sites in people with newly treated T1D compared to matched controls. Methods: All people from the UK Clinical Practice Research Datalink GOLD (1987–2017), of all ages with a T1D diagnosis code (n = 6381), were included. People with T1D were matched by year of birth, sex, and practice to controls (n = 6381). Fracture IRs and incidence rate ratios (IRRs) were calculated. Analyses were stratified by fracture site and sex. Results: The IR of all fractures was significantly higher in people with T1D compared to controls (IRR: 1.39 (CI95%: 1.24–1.55)). Compared to controls, the IRR for people with T1D was higher for several fracture sites including carpal (IRR: 1.41 (CI95%: 1.14–1.75)), clavicle (IRR: 2.10 (CI95%: 1.18–3.74)), foot (IRR: 1.70 (CI95%: 1.23–2.36)), humerus (IRR: 1.46 (CI95%: 1.04–2.05)), and tibia/fibula (IRR: 1.67 CI95%: 1.08–2.59)). In women with T1D, higher IRs were seen at the ankle (IRR: 2.25 (CI95%: 1.10–4.56)) and foot (IRR: 2.11 (CI95%: 1.27–3.50)), whereas in men with T1D, higher IRs were seen for carpal (IRR: 1.45 (CI95%: 1.14–1.86)), clavicle (IRR: 2.13 (CI95%: 1.13–4.02)), and humerus (IRR: 1.77 (CI95%: 1.10–2.83)) fractures. Conclusion: The incidence of carpal, clavicle, foot, humerus, and tibia/fibula fractures was higher in newly treated T1D, but there was no difference at other fracture sites compared to controls. Therefore, the higher incidence of fractures in newly treated people with T1D has been found mainly for distal fracture sites.