Skeletal Fragility in Adult People Living With Type 1 Diabetes
Authors' conclusion
Fracture risk assessment needs to be part of the management of people with T1D.
Study context
- Population
- Adults living with T1D
- Outcome
- Skeletal fragility in T1D
Main finding
As reported in the abstract
- Hip fracture risk up to sixfold higher in T1D than in nondiabetic controls and significantly higher than in T2D
- Hip fractures occur at a younger age, with worse consequences
- Risk of nonvertebral fractures also significantly increased
- Altered bone quality is a major underlying mechanism; areal BMD by DXA underestimates fracture risk
- TBS mildly reduced; its ability to predict fractures in T1D unknown
- BTM, particularly P1NP, suppressed and do not predict fracture risk in T1D
- T1D-related fracture risk factors: onset at age <20 years, longer disease duration, HbA1c ≥8%, hypoglycemic episodes, microvascular complications
- Data on efficacy of interventions to prevent or treat skeletal fragility in T1D are scant
- BMD testing recommended in T1D with poor glycemic control and/or microvascular complications
- Adequate calcium and vitamin D intake and fall prevention recommended
- Antiosteoporosis therapy recommended with previous hip or vertebral fragility fracture, >1 other fragility fracture, BMD T-score < −2.5 at femoral neck or spine, or increased FRAX score
Original publication
Skeletal Fragility in Adult People Living With Type 1 Diabetes. Endocr Pract. Published 29 March 2024. doi:10.
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