Incidence of fractures in patients with type 1 diabetes mellitus—a retrospective study with 4420 patients
Summary This retrospective study investigated the incidence of fracture in 4420 type 1 diabetes (T1DM) patients. Our findings indicate that patients with T1DM have an increased incidence of fractures. Further studies and preventive measures are urgently needed. Introduction The aim of this study was...
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| Veröffentlicht in: | Osteoporosis international 2020-07, Vol.31 (7), p.1315-1322 |
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| creator | Stumpf, U. Hadji, P. van den Boom, L. Böcker, W. Kostev, K. |
| description | Summary
This retrospective study investigated the incidence of fracture in 4420 type 1 diabetes (T1DM) patients. Our findings indicate that patients with T1DM have an increased incidence of fractures. Further studies and preventive measures are urgently needed.
Introduction
The aim of this study was to investigate the incidence of fracture in patients with type 1 diabetes mellitus (T1DM).
Methods
This study is based on the German Disease Analyzer database and included 4258 adult individuals with a T1DM diagnosis documented between January 2000 and December 2015 in 1203 general practices in Germany. Individual matching of T1DM and non-diabetic patients was performed. The cumulative incidence of new fractures was shown for up to 10 years after the index date using Kaplan-Meier curves. Cox proportional hazard models (dependent variable: incident fracture) were used to estimate the effect of T1DM on fracture incidence, as well as the effect of predefined variables on fracture incidence.
Results
After 10 years of follow-up, the cumulative fracture incidence was 18.4% for T1DM patients and 9.9% for non-diabetic patients (
p
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| doi_str_mv | 10.1007/s00198-020-05344-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2363085299</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2363085299</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-103de952d75b700330e191f9d5cdae9411c8a49623002fedcb2d87a8bfcec6dd3</originalsourceid><addsrcrecordid>eNp9kbtOHDEUhi1ExC6XF6CILNGkGTi25-YSoSQgrZSGSOksj30m8WbnEtvDajseIk_Ik-AwQCQKqlOc7__P5SfklME5A6guAgCTdQYcMihEnmfbPbJkuRAZl2WxT5YgRZXJnP1YkMMQ1pBEUlYHZCE4SOBVvSS_b3rjLPYG6dDS1msTJ4-Bup6OOjrsY6BbF3_RuBuRMmqdbjAmoMPNxsUpPNz_1dRj9EMY0UR3hzTEye5mVZ5zeDU6Jh9avQl48lyPyPcvn2-vrrPVt683V5erzIiqiBkDYVEW3FZFUwEIAcgka6UtjNWYzmGm1rksuQDgLVrTcFtXum5ag6a0VhyRT7Pv6Ic_E4aoOhdM2lf3OExBcVEKqAsuZULP3qDrYfJ92k7xnEFZMMbKRPGZMunK4LFVo3ed9jvFQP2LQs1RqBSFeopCbZPo47P11HRoXyUvv0-AmIGQWv1P9P9nv2P7CDEKlkQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2410651116</pqid></control><display><type>article</type><title>Incidence of fractures in patients with type 1 diabetes mellitus—a retrospective study with 4420 patients</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Stumpf, U. ; Hadji, P. ; van den Boom, L. ; Böcker, W. ; Kostev, K.</creator><creatorcontrib>Stumpf, U. ; Hadji, P. ; van den Boom, L. ; Böcker, W. ; Kostev, K.</creatorcontrib><description>Summary
This retrospective study investigated the incidence of fracture in 4420 type 1 diabetes (T1DM) patients. Our findings indicate that patients with T1DM have an increased incidence of fractures. Further studies and preventive measures are urgently needed.
Introduction
The aim of this study was to investigate the incidence of fracture in patients with type 1 diabetes mellitus (T1DM).
Methods
This study is based on the German Disease Analyzer database and included 4258 adult individuals with a T1DM diagnosis documented between January 2000 and December 2015 in 1203 general practices in Germany. Individual matching of T1DM and non-diabetic patients was performed. The cumulative incidence of new fractures was shown for up to 10 years after the index date using Kaplan-Meier curves. Cox proportional hazard models (dependent variable: incident fracture) were used to estimate the effect of T1DM on fracture incidence, as well as the effect of predefined variables on fracture incidence.
Results
After 10 years of follow-up, the cumulative fracture incidence was 18.4% for T1DM patients and 9.9% for non-diabetic patients (
p
< 0.001). A strong association between T1DM and fractures was found (HR, 2.01 (95% CI, 1.70–2.38)
p
< 0.001) in both female and male patients. Significant differences between T1DM and non-diabetes patients were found in lower leg/ankle, foot and toe, shoulder/upper arm, and rib(s), sternum and thoracic spine fractures. A significant association between higher age and fracture incidence was observed in T1DM patients.
Conclusions
In summary, we found that patients with T1DM have a twofold increased fracture rate compared with healthy controls. Furthermore, fractures were associated with increased age and high HbA1c values.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-020-05344-w</identifier><identifier>PMID: 32090278</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Adult ; Ankle ; Arm ; Diabetes ; Diabetes mellitus (insulin dependent) ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - epidemiology ; Diabetes Mellitus, Type 2 ; Endocrinology ; Female ; Germany - epidemiology ; Humans ; Hypoglycemia ; Incidence ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Orthopedics ; Osteoporosis ; Retrospective Studies ; Rheumatology ; Risk Factors ; Spine (thoracic) ; Sternum</subject><ispartof>Osteoporosis international, 2020-07, Vol.31 (7), p.1315-1322</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2020</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-103de952d75b700330e191f9d5cdae9411c8a49623002fedcb2d87a8bfcec6dd3</citedby><cites>FETCH-LOGICAL-c375t-103de952d75b700330e191f9d5cdae9411c8a49623002fedcb2d87a8bfcec6dd3</cites><orcidid>0000-0002-2124-7227</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-020-05344-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-020-05344-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32090278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stumpf, U.</creatorcontrib><creatorcontrib>Hadji, P.</creatorcontrib><creatorcontrib>van den Boom, L.</creatorcontrib><creatorcontrib>Böcker, W.</creatorcontrib><creatorcontrib>Kostev, K.</creatorcontrib><title>Incidence of fractures in patients with type 1 diabetes mellitus—a retrospective study with 4420 patients</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
This retrospective study investigated the incidence of fracture in 4420 type 1 diabetes (T1DM) patients. Our findings indicate that patients with T1DM have an increased incidence of fractures. Further studies and preventive measures are urgently needed.
Introduction
The aim of this study was to investigate the incidence of fracture in patients with type 1 diabetes mellitus (T1DM).
Methods
This study is based on the German Disease Analyzer database and included 4258 adult individuals with a T1DM diagnosis documented between January 2000 and December 2015 in 1203 general practices in Germany. Individual matching of T1DM and non-diabetic patients was performed. The cumulative incidence of new fractures was shown for up to 10 years after the index date using Kaplan-Meier curves. Cox proportional hazard models (dependent variable: incident fracture) were used to estimate the effect of T1DM on fracture incidence, as well as the effect of predefined variables on fracture incidence.
Results
After 10 years of follow-up, the cumulative fracture incidence was 18.4% for T1DM patients and 9.9% for non-diabetic patients (
p
< 0.001). A strong association between T1DM and fractures was found (HR, 2.01 (95% CI, 1.70–2.38)
p
< 0.001) in both female and male patients. Significant differences between T1DM and non-diabetes patients were found in lower leg/ankle, foot and toe, shoulder/upper arm, and rib(s), sternum and thoracic spine fractures. A significant association between higher age and fracture incidence was observed in T1DM patients.
Conclusions
In summary, we found that patients with T1DM have a twofold increased fracture rate compared with healthy controls. Furthermore, fractures were associated with increased age and high HbA1c values.</description><subject>Adult</subject><subject>Ankle</subject><subject>Arm</subject><subject>Diabetes</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - epidemiology</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Humans</subject><subject>Hypoglycemia</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporosis</subject><subject>Retrospective Studies</subject><subject>Rheumatology</subject><subject>Risk Factors</subject><subject>Spine (thoracic)</subject><subject>Sternum</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kbtOHDEUhi1ExC6XF6CILNGkGTi25-YSoSQgrZSGSOksj30m8WbnEtvDajseIk_Ik-AwQCQKqlOc7__P5SfklME5A6guAgCTdQYcMihEnmfbPbJkuRAZl2WxT5YgRZXJnP1YkMMQ1pBEUlYHZCE4SOBVvSS_b3rjLPYG6dDS1msTJ4-Bup6OOjrsY6BbF3_RuBuRMmqdbjAmoMPNxsUpPNz_1dRj9EMY0UR3hzTEye5mVZ5zeDU6Jh9avQl48lyPyPcvn2-vrrPVt683V5erzIiqiBkDYVEW3FZFUwEIAcgka6UtjNWYzmGm1rksuQDgLVrTcFtXum5ag6a0VhyRT7Pv6Ic_E4aoOhdM2lf3OExBcVEKqAsuZULP3qDrYfJ92k7xnEFZMMbKRPGZMunK4LFVo3ed9jvFQP2LQs1RqBSFeopCbZPo47P11HRoXyUvv0-AmIGQWv1P9P9nv2P7CDEKlkQ</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Stumpf, U.</creator><creator>Hadji, P.</creator><creator>van den Boom, L.</creator><creator>Böcker, W.</creator><creator>Kostev, K.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2124-7227</orcidid></search><sort><creationdate>20200701</creationdate><title>Incidence of fractures in patients with type 1 diabetes mellitus—a retrospective study with 4420 patients</title><author>Stumpf, U. ; Hadji, P. ; van den Boom, L. ; Böcker, W. ; Kostev, K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-103de952d75b700330e191f9d5cdae9411c8a49623002fedcb2d87a8bfcec6dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Ankle</topic><topic>Arm</topic><topic>Diabetes</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - epidemiology</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Humans</topic><topic>Hypoglycemia</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporosis</topic><topic>Retrospective Studies</topic><topic>Rheumatology</topic><topic>Risk Factors</topic><topic>Spine (thoracic)</topic><topic>Sternum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stumpf, U.</creatorcontrib><creatorcontrib>Hadji, P.</creatorcontrib><creatorcontrib>van den Boom, L.</creatorcontrib><creatorcontrib>Böcker, W.</creatorcontrib><creatorcontrib>Kostev, K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stumpf, U.</au><au>Hadji, P.</au><au>van den Boom, L.</au><au>Böcker, W.</au><au>Kostev, K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of fractures in patients with type 1 diabetes mellitus—a retrospective study with 4420 patients</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>31</volume><issue>7</issue><spage>1315</spage><epage>1322</epage><pages>1315-1322</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>Summary
This retrospective study investigated the incidence of fracture in 4420 type 1 diabetes (T1DM) patients. Our findings indicate that patients with T1DM have an increased incidence of fractures. Further studies and preventive measures are urgently needed.
Introduction
The aim of this study was to investigate the incidence of fracture in patients with type 1 diabetes mellitus (T1DM).
Methods
This study is based on the German Disease Analyzer database and included 4258 adult individuals with a T1DM diagnosis documented between January 2000 and December 2015 in 1203 general practices in Germany. Individual matching of T1DM and non-diabetic patients was performed. The cumulative incidence of new fractures was shown for up to 10 years after the index date using Kaplan-Meier curves. Cox proportional hazard models (dependent variable: incident fracture) were used to estimate the effect of T1DM on fracture incidence, as well as the effect of predefined variables on fracture incidence.
Results
After 10 years of follow-up, the cumulative fracture incidence was 18.4% for T1DM patients and 9.9% for non-diabetic patients (
p
< 0.001). A strong association between T1DM and fractures was found (HR, 2.01 (95% CI, 1.70–2.38)
p
< 0.001) in both female and male patients. Significant differences between T1DM and non-diabetes patients were found in lower leg/ankle, foot and toe, shoulder/upper arm, and rib(s), sternum and thoracic spine fractures. A significant association between higher age and fracture incidence was observed in T1DM patients.
Conclusions
In summary, we found that patients with T1DM have a twofold increased fracture rate compared with healthy controls. Furthermore, fractures were associated with increased age and high HbA1c values.</abstract><cop>London</cop><pub>Springer London</pub><pmid>32090278</pmid><doi>10.1007/s00198-020-05344-w</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2124-7227</orcidid></addata></record> |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Ankle Arm Diabetes Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - epidemiology Diabetes Mellitus, Type 2 Endocrinology Female Germany - epidemiology Humans Hypoglycemia Incidence Male Medicine Medicine & Public Health Original Article Orthopedics Osteoporosis Retrospective Studies Rheumatology Risk Factors Spine (thoracic) Sternum |
| title | Incidence of fractures in patients with type 1 diabetes mellitus—a retrospective study with 4420 patients |
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