TOPLINE:

Both type 1 diabetes (T1D) and type 2 diabetes (T2D) vs no diabetes were associated with a higher incidence of subtrochanteric or femoral shaft (ST or FS) and hip fractures, but after adjusting for age, only the association for T1D remained significant. Among patients with femoral fractures, both T1D and T2D were associated with higher odds of ST or FS fractures vs hip fractures.

METHODOLOGY:

• Researchers conducted a nationwide population-based observational study to evaluate the incidence rates of femoral fractures and the site-specific susceptibility to ST or FS and hip fractures in patients with T1D, those with T2D, and individuals without diabetes.
• They evaluated 204,096 femoral fractures in adults aged 65 years or older with T1D, with T2D, or without diabetes, using data from two linked Danish health registries from 1997 to 2021.
• Of the total included fractures, 33,939 (16.6%) were ST or FS fractures and 170,157 (83.4%) were hip fractures.
• Femoral fractures were identified using standard diagnostic and operation classification codes.

TAKEAWAY:

• Overall, ST or FS fractures were reported in 1.9% of patients with T1D and 11.9% of those with T2D, whereas hip fractures were reported in 1.7% and 11.4% of patients with T1D and T2D, respectively.
• Both patients with T1D and those with T2D had a higher incidence of ST or FS and hip fractures than individuals without diabetes; patients with T1D had higher incidence rates of ST or FS fractures (incidence rate ratio [IRR], 2.53 vs 1.08) and hip fractures (IRR, 2.17 vs 1.06; P < .05 for both) than those with T2D.
• After adjusting for age, the association remained significant in those with T1D.
• Among patients with femoral fractures, T1D (odds ratio [OR], 1.14; P = .002) and T2D (OR, 1.05; P = .008) were modestly associated with higher odds of ST or FS fractures vs hip fractures.

IN PRACTICE:

"These findings suggest that ST/FS fractures are of relatively increasing clinical importance, particularly for people with type 1 diabetes, because of the increased femoral fracture risk and possibly higher ST/FS susceptibility," the authors wrote.

SOURCE:

This study was led by Asger A. Bech, Steno Diabetes Center North Denmark, Aalborg University Hospital, Gistrup, Denmark. It was published online on May 27, 2026, in Diabetes Care.

LIMITATIONS:

This study did not report any limitations.

DISCLOSURES:

This study received funding from the Danish Diabetes and Endocrine Academy and Steno Diabetes Center North Denmark. One author declared serving as the head of research in the Steno Diabetes Center North Denmark, sponsored by the Novo Nordisk Foundation. Two authors declared holding shares in Novo Nordisk, and one of them also reported receiving a grant from the Danish Diabetes and Endocrine Academy.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.