Diabetes and Femoral Fracture Patterns: A Nationwide Registry Study (1997-2021).

Bech, Asger A; Kvist, Annika V; Vestergaard, Peter; Rasmussen, Nicklas H · Diabetes Care · 2026

retrospective_cohort · Level III

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Abstract

To investigate the impact of diabetes on incidence rates (IRs), incidence rate ratios (IRRs), and site-specific fracture susceptibility of subtrochanteric/femoral shaft (ST/FS) and hip fractures. Using Danish registries, we estimated IRs, IRRs, and fracture site associations of ST/FS and hip fracture (1997-2021) in adults ≥65 years old with type 1 diabetes, with type 2 diabetes, and without diabetes. IRRs were significantly higher in those with type 1 diabetes (ST/FS 2.53, P < 0.001; hip 2.17, P < 0.001) and type 2 diabetes (ST/FS 1.08, P = 0.002; hip 1.06, P = 0.008) compared with no diabetes. After age adjustment, only type 1 diabetes remained significantly increased. Adjusted analysis found both type 1 (OR = 1.14, P = 0.002) and type 2 (OR = 1.05, P = 0.008) diabetes to be significantly associated with higher odds of ST/FS compared with hip fractures. Type 1 diabetes was associated with increased incidence of femoral fractures and slightly higher odds of ST/FS than hip fractures after adjustment.