Insights from Secular Trend of Major Osteoporotic Fractures in People with and without Diabetes: 15-Year Population-based Study (2009–2023)
Authors' conclusion
Diabetes-specific excess fracture risk persisted despite improved glycemic control.
Study context
- Population
- Individuals aged ≥50 years who sustained major osteoporotic fractures (MOF) between 2009 and 2023, Hong Kong territory-wide electronic health database86,263 hip, 124,268 nonhip fractures
- Exposure
- Diabetes vs nondiabetes
- Outcome
- Secular trend in rate ratios of MOF between diabetes and nondiabetes, as AAPC
- Follow-up
- 2009–2023
Methodological detailsterritory-wide electronic health database, joinpoint regression, age-standardized to 2021 Hong Kong Census mid-year population
- Territory-wide electronic health database
- Joinpoint regression
- Age-standardized to 2021 Hong Kong Census mid-year population
Main finding
As reported in the abstract
Hip fracture rate ratio, diabetes vs nondiabetes: AAPC
Average annual percentage change (AAPC) in rate ratio (women; rate ratio 4.1)
−0.16 %
95% CI −0.65 to +0.35P = 0.54
women
AAPC in rate ratio (men; rate ratio 2.5)
+0.07 %
95% CI −0.58 to 0.71P = 0.83
men
Observational data: associations, not effects.
Further findings
Nonhip fractures
- Persistent gap of diabetes-specific excess risk similarly observed for nonhip fractures
Age-standardized mean HbA1c · 2009–2023
- Improved from 59 mmol/mol (7.5%) to 53 mmol/mol (7%), with fewer severe hypoglycemic episodes
DXA screening and anti-osteoporosis medication
- Screening DXA prevalence increased, more so in women with diabetes
- Anti-osteoporosis medication prescriptions increased in both, to a lesser extent in diabetes
Original publication
Insights from Secular Trend of Major Osteoporotic Fractures in People with and without Diabetes: 15-Year Population-based Study (2009–2023). Endocr Pract. Published 4 July 2026. doi:10.
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