Type 1 diabetes and risk of fracture: meta-analysis and review of the literature

Aims To conduct a systematic review and meta‐analysis of observational studies in order to assess the association between Type 1 diabetes and fractures. Background The risk of fracture in men and women with Type 1 diabetes has not been studied in a large prospective well designed cohort. Methods Data were selected from Medline and Embase and s from annual scientific meetings of various diabetes and bone and mineral societies. Published studies that reported the fracture risk in people with Type 1 diabetes in comparison with people without diabetes between 1990 and July 2014 and s from various annual meeting (2005 onwards) were included in the present meta‐analysis. Data were extracted from the text of included publications or from s of conferences. Results The 14 studies that met the inclusion criteria reported 2066 fracture events among 27 300 people with Type 1 diabetes (7.6%) and 136 579 fracture events among 4 364 125 people without diabetes (3.1%). The pooled relative risk of any fracture in people with Type 1 diabetes was 3.16 (95% CI 1.51–6.63; P = 0.002). Women and men with Type 1 diabetes had a four and two times higher risk of any fractures, respectively, compared with people without diabetes. The pooled relative risks of hip fractures and spinal fractures were 3.78 (95% CI 2.05–6.98; P