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Disease Epidemiology/Clinical Course

Poster Gallery-Disease Epidemiology/Clinical Course

(P-380) Comparison of 21-year Sex-specific Fracture Incidence Rates Between Type 1 and Type 2 Diabetics and Non-diabetics in Denmark (1997 – 2017)

Location: Poster Gallery-Disease Epidemiology/Clinical Course

    Presenting Author(s)

  • AK

    Annika Kvist

    Swiss Federal Institute of Technology
    Zurich, Zürich, Switzerland

    • Co-Author(s)

  • MN

    Mohamad Nasser

    Department of Endocrinology and Metabolism, Molecular Endocrinology & Stem Cell Research Unit (KMEB) Odense University Hospital, Odense, Denmark, University of Southern Denmark, Odense, Denmark, Denmark

  • Andrea M. Burden

    Professor
    ETH Zurich
    Zurich, Switzerland

  • PV

    Peter Vestergaard

    Department of Clinical Medicine, Aalborg University, Aalborg, Denmark, Denmark

  • MN

    Morten F. Nielsen

    Department of Endocrinology and Metabolism, Molecular Endocrinology & Stem Cell Research Unit (KMEB) Odense University Hospital, Odense, Denmark, University of Southern Denmark, Odense, Denmark, Denmark

Background: Major osteoporotic fractures have declined in Nordic and western countries over the last two decades, despite an aging society of the general population. However, little is known if the decreasing trend of fragility fractures, including MOF, is similar in patients with diabetes.

Objectives: To investigate the incidence rate (IRs) of fragility fractures in adult (age 18+) patients with Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D) in Denmark over the period 1997-2017, stratified by sex.

Methods: This observational study identified all patients aged 18+ with a bone fracture (excluding skull and facial fractures) between 1997 and 2017 from the Danish National Health Service Register and linked to the Danish Medicines Agency Register of Medicinal Products Statistics (RMPS). Total, and gender-specific IRs of fragility fractures per 10,000 person years (PYs) were estimated. All analyses were stratified by diabetes diagnosis, as T1D, T2D, and non-diabetic.

Results: Between 1997 and 2017 fracture IRs per 10,000 PYs declined among T1D patients (from 426.6 to 410.8 ), T2D patients (from 452.3 to 354.3), and non-diabetics (from 192.3 to 169.5). Sex-specific differences were observed, with the largest decline in IRs observed among men in all strata. Among males there was an 8.3% decline in the IR for fracture among T1D (348.0 to 319.3), a 32.0% decline among T2D (385.9.9 to 262.3), and a 13.0% decline among non-diabetics (177.2 to 154.2). Among women, the IRs per 10,000 PYs increased 4.7% from 530.1 to 555.1 per among T1Ds but decreased from 522.4 to 468.2 (10.4%) for T2D, and from 206.7 to 198.6 (3.9%) for non-diabetics between 1997 and 2017, respectively.

Conclusions: We identified a declining trend of fractures among diabetics between 1997 and 2017 except for women with T1D. The decline was more prominent in T2D patients, compared to non-diabetics, and the reduction in fracture incidence is substantially higher in male patients with T2D, compared to female patients with T2D.