- Higher haemoglobin A1c (HbA1c) level is associated with an increased risk for fracture in people with newly diagnosed type 1 diabetes (T1D).
- Risk increases by 7% for each percentage increase in HbA1c level.
Why this matters
- Findings may be considered in fracture risk assessment and even in prompting early anti-osteoporotic intervention in patients with T1D, especially in those presenting with other established risk factor.
- This retrospective study identified 5368 people with newly diagnosed T1D between January 1995 and May 2016 from The Health Improvement Network database.
- Longitudinal HbA1c measurements from diagnosis to fracture were collected.
- Primary outcome: any fracture recorded by general practitioners.
- Funding: None disclosed.
- 525 fractures over 37830 person-years of follow-up with an incidence rate of 14 per 1000 person-years were observed.
- HbA1c level was significantly associated with increased risk for fracture (adjusted HR [aHR], 1.07%; P=.002) in patients with T1D representing 7% increase with each percentage increase in HbA1c levels.
- Compared with HbA1c
- 53-58.5 mmol/mol, 7-7.5% (aHR, 1.02; 95% CI, 0.70-1.49).
- >74.9 mmol/mol, >9% (aHR, 1.23; 95% CI, 0.91-1.65).
- Measure of bone fragility not included in the analysis.