Determinants of fracture in adults with type 1 diabetes in the USA: Results from the T1D Exchange Clinic Registry

Ruban Dhaliwal, Nicole C. Foster, Claire Boyle, Mona Al Mukaddam, Ruth S. Weinstock, Michael R. Rickels, Viral N. Shah, Linda A. DiMeglio

Research output: Contribution to journalArticle

10 Scopus citations


Aims: To examine the prevalence/determinants of fracture in the T1D Exchange Clinic Registry. Research design/methods: Adults (≥18 years) with T1D duration ≥5 years, diagnosed before age 45 years completed a fracture questionnaire. Additional characteristics were collected from registry data. Only fractures reported as occurring after T1D diagnosis were included. Characteristics were compared between those with and without fractures. Results: Respondents included 756 adults (mean age 39 ± 16 years, 28% ≥50 years, 63% female, 90% non-Hispanic White, diabetes duration 24 ± 14 years); 48% reported ≥1 fracture since diagnosis. Of the 659 reported fractures, 24% involved metatarsal/toe, 21% metacarpal/fingers, 14% fibula/tibia, 5% hip/pelvis/femur and 3% vertebrae. Those with fracture were more likely to be older (43 ± 16 vs. 36 ± 14 years), have longer T1D duration (28 ± 14 vs. 20 ± 12 years), been diagnosed with T1D before age 20 years (79% vs. 71%) compared to those without fracture (all p-values < 0.01). Conclusions: Data from this national sample suggest fractures in adults with T1D are common at young age and frequently involve peripheral sites. Age, longer diabetes duration, and T1D diagnosis prior to peak bone mass accrual are notable risk factors. Further research is needed to examine the impact of these determinants on fracture risk in T1D.

Original languageEnglish (US)
Pages (from-to)1006-1011
Number of pages6
JournalJournal of Diabetes and its Complications
Issue number11
StatePublished - Nov 2018


  • Bone mineral density
  • Bone quality
  • Diabetes
  • Fracture
  • Osteoporosis
  • Type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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