Contemporary Risk of Hip Fracture in Type 1 and Type 2 Diabetes: A National Registry Study from Scotland


The purpose of this study was to compare contemporary risk of hip fracture in type 1 and type 2 diabetes with the non-diabetic population. Using a national diabetes database, we identified those with type 1 and type 2 diabetes aged 20–84 years alive anytime from 01/01/2005 to 12/31/2007.

All hospitalised events for hip fracture in 2005–2007 for diabetes patients were linked and compared to general population counts. Age- and calendar- year-adjusted Incidence Rate Ratios (IRR) were calculated by diabetes type and sex. One hundred and five hip fractures occurred in 21,033 people (59,585 person-years) with type 1 diabetes; 1,421 in 180,841 people (462,120 person-years) with type 2 diabetes and 11,733 hip fractures over 10,980,599 person-years in the non-diabetic population (3.66 million people). Those with Type 1 diabetes had substantially elevated risks of hip fracture compared to the general population Incidence risk ratio (IRR)3.28 [95% Confidence Interval: 2.52–4.26] in men and 3.54 [2.75–4.57] in women. The IRR was greater at younger ages but absolute risk difference was greatest at older ages. In type 2 diabetes, there was no elevation in risk among men (IRR 0.97 [0.92–1.02]) and the increase in risk in women was small (1.05 [1.01–1.10]). There remains a substantial elevation relative risk of hip fracture in people with type 1 diabetes but the relative risk is much lower than in earlier studies. In contrast overall there is currently little elevation in overall hip fracture risk with type 2 diabetes but this may mask elevations in risk in particular subgroups of type 2 diabetes patients with different BMI or diabetes duration or drug exposure. © 2013 American Society for Bone and Mineral Research.

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Eleanor J Hothersall, Shona J Livingstone, Helen C Looker, S. Faisal Ahmed, Steve Cleland, Graham P Leese, Robert S Lindsay, John McKnight, Donald Pearson, Sam Philip, Sarah H Wild and Helen M Colhoun.